09/11 - Billo Day 2 on Lantus | AMPS 194 | +3 126

So Billo's BG levels are much different than yesterday, there is a significant difference. I will be monitoring her levels every two hours to see if I get the same flat curve that I got yesterday. Are these levels too low? I will also be collecting a ketone reading soon!

 

Nice numbers. Are you going to follow SLGS or TR? I would feed a little low carb ff.

 

SLGS. Okay I will! She just ate a few hours ago, she’s in the middle of her usual nap at this time. Should I feed her now or wait until she usually wakes up (which is in about an hour)?

 

Don't wake her. She's not too low.

 

Just to update, Billo's BG has been dropping since the feeding, from +5 75, +6 59. I am going to take measures to increase her BG by feeding her a high carb wet food and then I will test again in about 20 min. Just wanted to keep you guys updated

@Panic @Butters & Lyla @Sue and Luci @Red & Rover (GA)

 

No need to feed HC food at this point...you could test again without food - to see if she's still dropping. Those are really very nice numbers...maybe a little bit of low carb food just to keep her from dropping...

 

She won't need high-carb yet, not unless she drops under 50. She's earned a reduction though! Congrats.

 

So under 90 on SLGS you'll need to reduce tonight by .25. Your new dose will be 2.25.

Do you have calipers? If not, I'd suggest getting these
https://www.harborfreight.com/hand-...rs-micrometer/4-in-digital-caliper-63710.html

They really help when it comes to splitting the increments and fine dosing - consistency with Lantus is important - same amount every time, unless there's an increase or reduction;same time of day 12 hours apart.

 

Noted - she seems a little lethargic which is why I thought of the HC food. But okay I will monitor her for another 20 min and see if she drops below 50.

Oh my. This was quick I’m glad!!

Sounds good I’ll make sure to do so! I do not own calipers but I’ll look into these now.

Thank you all!!

 

Is this the time of day she usually has a cat nap? Or is she trying to get up and walk around and is unable to?

Lethargy typically does not occur in cats in the 50's...

 

She’s usually up and about during this time, she’s following me around right now because she heard the sound of her food drawer opening (oops lol) and she is walking fine. I just got worried because she woke up from her usual nap, ate, and then went to lied down for another nap after staring out the window for a couple minutes.

 

I just checked her BG again, she’s at 41. I will feed her a little bit and test again!

 

Yeah sorry haha you'll have to re-learn a bit about when to intervene with HC since she's not on NPH anymore.

If it helps, I wrote this down in my log book to reference after someone helped me with low numbers.
Someone may have a different opinion because I thiiink this was when I was using Prozinc, but I still followed it on Lantus.

50-70 BG
Give 1-2 tsp LC, retest 20-30 minutes
If dropping, little more LC and repeat process
If holding, no more food but retest in 30 min
If rising, no more food and take a "poke break" (check 1 hr)

If you're early in the cycle though you might want to intervene with M/HC.

 

Harbor Freight doesn't ship to Canada, unfortunately. I got mine from Lee Valley Tools, if you have that in Edmonton. Canadian Tire carries them though they were much more expensive at full price. And of course, you can find them on Amazon.

Sorry I didn't see your tag til I came on.
Yes I would give her HC with that 41.

 

Feed her HC with this number. You don't want her staying this low.

 

Regarding HC, remember the carbs are in the gravy, so make sure she gets gravy.
Sue and Elizabeth may not be on anymore, but I'll stay on with you if they aren't around.

 

@Abdullah ...by my count, your next test should be in about 10 minutes.

 

Yes, agree with @Butters & Lyla - general rule of thumb - 'Feed the 40's!'

That's definitely too low...get away from those sharkies Billo!

 

This definitely applies! MC & HC is generally reserved for early on and/or below 50.

 

Sorry about getting back to you a little late @Butters & Lyla! I was monitoring Billo, she has gone back up to 50, and is staying around there for about an hour now

 

What time was that at? Can you post all of the tests you've done and how much you fed her?

Then can you add all of your tests over the past hour to your spreadsheet?

 

We want to keep her from dropping below 50 again, so you'll need to keep monitoring. So I'm asking about when you fed and tested so I can see how she is reacting to the HC food.
Also, what kind of HC food did you give her?

 

I've updated the SS.

I gave her about 2 tsp of LC FF that was suggested earlier, I tested after 20 min, and saw that she had risen slightly, so I decided to stop feeding and test again after another 20 min. At +7 she was 41, +7.20 she was 44, +7.40, +8 she's at 50.

I have HC Meow Mix Chicken and Liver, should I go ahead with the HC or stick with the LC?

 

Stick with LC. She is rising from it, and it is later in the cycle, so maybe the insulin is waning a little.

 

Sounds like a plan! I'll feed her and test. Get back to you in 20 min!

 

Excellent job with the testing and feeding.
For future, when she drops into the 40s, that is the time to use MC or HC to bring her back up, depending on how carb sensitive she is. Once she is over 50, then you can continue to steer with LC if she isn't dropping lower. As Sue said, "Feed the forties".

 

Sounds good! I'll make sure to keep that in mind. Thank you for staying by my side

 

Woo Billo! If she doesn't bounce from this (and so far she doesn't seem to be a bouncy girl) it may be helpful to get a +11 to see if you need to post and ask for dosing assistance this evening if she is still low.

I would put the info on what you fed in the Remarks column of your SS, that way you/others can look back to see what you did during the lower numbers food-wise.

 

Billo's BG at +8.20 is 55! Rising, slowly but surely.

That sounds like a good plan! I'll make sure to post here and then we can take things from there. Oh no way, I hadn't even scrolled over there! I was making remarks in my notepad lol, if only I had scrolled over a little!

 

She is making you work for it. Keep at it.
Remember what @Panic posted:
50-70 BG
Give 1-2 tsp LC, retest 20-30 minutes
If dropping, little more LC and repeat process
If holding, no more food but retest in 30 min
If rising, no more food and take a "poke break" (check 1 hr)

If you're early in the cycle though you might want to intervene with M/HC.

 

I wouldn't give a 1 hour poke break at this point. She is rising but ever so slowly.

 

She really is making me work for it lol.

Sounds good! I'll keep feeding and testing! Should I continue with LC or introduce M/HC? We're not too early in the cycle anymore, it has been about two hours now.

 

Someone thought of everything!

LC is fine now that she's over 50.

 

Yeah I didn't write it in my log book but I think it was implied that the 1 hr poke break isn't earned until you're over 70. I should edit that.

 

He was using LC when Billo was 41. I think he had gone off to test and missed the comments on food type. He knows to use M/HC next time.

 

Yeah no worries! I understood that the poke break is once you're over 70 hahaha!

Yup!

 

Hahah okay good! I knew that I knew that, because when I wrote it I wrote it for me, but that doesn't mean someone else knows what I meant.

Are you planning on showing your current vet Billo's spreadsheet? S/he should be pleased to see what Lantus can do (and on the second day!!).

 

hahah no worries, I understood

Yes I definitely am, especially because of these results that I got today! I am just waiting for a call back from my vet, he will call and tell me when he is available, hopefully early next week!


Billo's BG hasn't changed since feeding at +8.20. She is at 55 +8.40.

 

Just double checking.
You gave 2.5 units using U100 syringes (orange cap).
If you used syringes with half unit markings, 2.5 units is marked in green on the left hand image.
If you used syringes with full unit markings only, 2.5 units would be halfway between the 2 unit and the 3 unit marks (red).

 

I found this document on the forum just a few days ago! I saved the picture in case I had to drop the dose by .25u. Thank you for bringing it up though, I appreciate it!

 

Billo's BG at +9 dropped just slightly to 52. I think it may be time to give her the M/HC wet food instead of the LC?

 

Yes do that.

 

I'll be waiting to see your next test. Hopefully she comes up more.
You're following SLGS? I'm not as familiar with that. I'll need to check but I don't think you shoot if under 90. And you need to withhold food for 2 hours prior to shooting.
We'll see what happens between now and +10

 

Correct.

 

Gotta say I'm so pleased with Billo! She is doing so well!

 

She's at 57 now after feeding!

Yes that's correct!

Thank youuu! It's been a wild ride, and lots of stress and anxiety on my part lol but thank you!

 

Test and feed again in an hour unless in 60’s. It could still go down again.

 

In 30 min she will be 2 hours away from her shot. Should I still feed her now?

 

Test right before tge 2 hour mark. If lowish you can then give a little food and still have 2 hours to see. Or else test now and again in two hours.

 

Sounds good!!

 

What were you feeding before switching to low carb Fancy Feast a few days ago?

 

She was on meow mix wet food (M/HC) twice a day and free feeding kibble which was HC

 

And removing that food is why you are seeing the lower numbers. Switching to low carb food can change a cat's numbers by up to 100.

 

That is understandable. There is no kibble in her diet now, only LC FF. I wish I had made the change sooner

She's at 52 now. this is the 2 hour mark prior to shooting. I'm going to feed her a little now and then stop for the remaining two hours, just so she doesn't fall any lower. She has stayed between this 50-60 range for almost 3 hours now, despite the constant feeding which is really interesting.

 

Please test again in an hour. She could drop again.

 

Yes for sure! I definitely will

 

Should Billo be getting a bigger reduction? I didn't realize she just switched to LC, and the depot isn't even filled yet.

 

I think I would think about skipping tonight if no history of DKA. This will be the second decrease ,Let’s see the pmps.

 

Billo has no history of DKA.

We're looking at +11 at 61 on the dot. It definitely went up after that last feeding.

 

The old depot will be in play. I believe 2.5. I hope he comes up a lot in the next hour. Otherwise I’d consider a token dose. What do the rest of you think?

 

I'd be inclined to skip, but not a depot expert. The fact that she just switched to LC would mean 2.5 would have been too much to start her on. Billo did already earn a 0.25 reduction from 2.5u.

 

I couldn’t remember the dose and was on my phone. Skipping is fine since no DKA in the picture. Then the morning dose should be 2.25 unless still low. That should be decided in the morning. Also he might not be too hungry.

 

I'm going to measure her PMPS soon, I have a feeling it is still rising but not significantly. I think I'd be inclined to skip tonight as well, and then we can decide the dose tomorrow morning depending on her AMPS

 

The thing is i never would have switched insulin until you knew what the food change was doing. It’s hindsight now and making me want to be more cautious though. We haven’t even seen the full depot form yet.

 

When was the food change, Abdullah? I didn't even realize you'd done it until Kel said something.

 

The food change was on Tuesday, we still carried on with NPH until Wednesday. today is Day 2 on Lantus.

 

PMPS is 59. Lets discuss the decision on dosing?

 

Skip. I believe the food change is having a big effect. Sometimes cats have a dramatic response to Lantus at first. It might continue. I don’t know. What do you think?

 

Should I continue feeding her M/HC for her evening meal, because the BG is still low, or should I continue with LC FF?

 

I'd like to skip too. I'm leaning towards giving her the M/HC food to be on the safe side, in case her BG drops any lower. I want to measure her AMPS in the morning and then decide how much of a dose reduction is needed

 

Post the amps. I’d get a test about a half hour or hour before so you can see if her numbers are on the rise. I’d give mc since you are skipping. Test in 2 hours

 

Sounds like a plan! I’ll test +2, thank you so much !!

 

Would you add your PMPS to the title and the +2 please? Put NS on your spreadsheet. It’s a good idea to write what you fed and when in the comments So you remember for next time.

 

Done! I'll make sure to add PMPS and the +2 to the title for tomorrow. I'll make sure to add comments to the remarks column starting now. Thank you for the guidance

 

Your welcome. Good job today. It’s not easy.

 

Agreed, fabulous work! Give Billo some scritches for me!

 

Thank you for the guidance. I certainly couldn’t have done it without you all. I ask for help at every step along the way, so I thank you for being patient with me