Discussion in 'Lantus / Levemir / Biosimilars' started by Max & Lori, Sep 10, 2021.
Max is 48. He just woke me up vomiting a little. Please help.
Hi Lori, I am here, don't worry. When did he last eat?
Please feed some HC and test in 30 mins?
I typed LC by mistake and corrected to HC. In case you missed the edit.
Hi Bhooma he last ate at PMPS+4. I just saw he didn’t eat what was in his feeder that I’d left out. He is meowing like he’s hungry. Just gave him FF gravy lovers. How much to give him?
Give him a couple of teaspoons?
Hopefully we won't have to feed after this and he will come up and you can shoot with just a little delay at AMPS.
Okay I did. I will recheck in 15 minutes.
He’s 59 now. Feed more?
Are we at +10.5? Later?
We are at almost +10.75
His AMPS dose is due in 1 hr and 10 mins from now.
If you feed, you will have to wait till 2 hours after this meal to shoot. Do you have that flexibility in your schedule?
Alternatively, we could not feed and see if he stays up but there is a chance he may not.
I can feed him. What do I give him HC?
You can wait 2 hours from now to shoot?
Feed LC since it's the end of the cycle and he should hopefully start heading up anyway.
Yes I can. I don’t have to leave the house until 7 hours from now.
Ok. Feed LC and test at +11.5.
Please remove the 911 from the title now. Thanks!
Thank you for staying with me!
Could you also please add the latest tests to the title, so nobody gets a shock looking at that 48! LOL.
Okay I did! I’m somewhat between shock and zombie mode right now myself lol.
I can imagine! Going to bed with 311 and waking up to a 48!
He pretty much did the same thing in the AM cycle day before yesterday.
I know…I don’t understand what is going on. I’m going to be afraid to give him 10.5 units when it’s time. Maybe that’s too much? He’s had a lot going on lately with ear infections and stuff and now he’s better so maybe that was making his glucose high when he was sick. I’m getting ready to check again.
He’s now 74.
The LC was at around +10.75. Let's see where he is at +12.5?
Stay safe, pretty Max. I like your new picture.
How long till +12.5, Lori?
Getting ready to check now.
This is crazy. He's dropped to 61! I double checked.
We are now 2.5 hours after the HC and nearly 2 hours after the LC?
No I think its 2 hrs after HC and 1.5 after LC. Isn't that right?
OK. I thought the HC was at +10 and LC was +10.5/+10.75?
Do you feel comfortable to shoot if he is above 50 in another 15 mins? He has earned a reduction to 9.5U today.
If not, you could also try a token dose of 5U.
Depends on whether you can monitor. You said you have to leave the house in 5 hours from now?
I do have to leave in 5 hours. Since he's dropped some, should I feed him and give only the 5 units? I'm not sure what is going on with him. You are right. I got confused with the times.
OK. Let's do the token dose considering you have to leave. Even with the token dose the depot will affect the first part of the cycle.
OK thanks Bhooma. Feed LC and recheck when?
Get a test before shooting. That will be your AMPS and then let's start with a +1?
I just rechecked again and now it's 54. He's eating his LC. Still give 5 units?
Yes. You can carb him up later in the cycle, if needed. Shoot and test in 30 mins.
I will retest in 15 minutes. I gave the 5 units 15 mins ago. Should I make a new post for AMPS for this?
Congrats on shooting your first green preshot!
Not necessary. This today's thread. Just add the AMPS to the title. Knock off the numbers between +10 and AMPS if you run out of space.
He is 67 now 30 minutes after dose. Gosh doing that scared the mess out of me lol. You are awesome Bhooma! I would have freaked out without you. If I were there I would give you the biggest hug!!! When should I recheck him? He's trying to hide from me now lol.
Remind me what higher carb food you have?
I have FF gravy lovers which I gave him half the 3 oz can earlier, and I have some Temptations treats also.
Which one? The Gourmet Beef Feast in Gravy is 20% (HC) but the others are 15% (MC).
Test again at +1? He is okay with so many pokes?
He's a good cat. He's okay. My food is the "FF Gravy lovers turkey feast in roasted turkey flavor gravy" which he had this morning and the other kind I have is "FF Liver and Chicken Feast in Gravy," it doesn't say gravy lovers on that one. He will not eat beef at all.
From Dr. Lisa's food chart, I think:
This is FANCY FEAST - Gravy Lovers Turkey Feast in Gravy - 15% carbs
FANCY FEAST - Grilled in Gravy - Grilled Liver & Chicken Feast in Gravy - 13%
Does it say Grilled on the can?
So both are MC and not HC. Do you have honey or karo?
2 mins is what I have.
It does say grilled. I didn't know that. I do have some Karo.
He is at 78. What can I get that is HC so I will have it next time? I have some Purina Proplan Tuna.
OK. Feed him some more LC and get a +2?
FANCY FEAST - Gravy Lovers - Gourmet Beef Feast in Gravy is 20%
He is 83 at +2
Looking good! Will he eat a little more LC?
Test at +3?
Okay. I will see if he will eat again.
He ate a little bit more of it. Not much though. He got back in his bed to lay down. I gave him a couple of the Temptations treats and he did eat those 2 treats.
Oh No! Those treats are high carb!
Oh I’m sorry! He didn’t want to eat but a bite of the LC so I gave him that. I hope I didn’t mess anything up! I rescheduled my doctors appointment because I am afraid to leave him today.
Oh you didn't have to do that! He is flat and it should be okay to leave by +5.
I know. I am just too anxious to leave him by himself. That's just me. It's no problem, I was rescheduled for next week. It was just for a recheck, I am fine. I'm just not used to all of Max's issues yet, but I will get there. He acted like his asthma was going to flare up a few minutes ago. He coughed a couple of times, but he's okay now. I didn't have to give him his rescue inhaler and he's not on the steroid inhaler anymore.
This same thing happened last time he dropped low, he had an asthma attack right before that (but that time was worse). I don't know if the two things have anything to do with each other.
He is 110 now at +3. I shouldn't have given him those 2 treats. I haven't given him those at all since he was diagnosed. I guess I was just trying to get him to eat something since he didn't want the LC. I won't do that again. So sorry!
I don't have any experience with asthma but I don't think the two are connected. @Wendy&Neko
That's probably the Temptation treats at work
I edited my last post....I am so sorry! I haven't given him those since he was diagnosed. I knew better than that. I will be better at following directions if this happens again. I hope I didn't wear out my welcome with you!
Just saw the edit. No need to apologize Lori! We have all been where you are and fed high carbs when we saw lower numbers!
Of course you did not wear out your welcome. Not at all!
Well thank you so much. You've been amazing. When do you recommend that I test again or what do you recommend I do?
A combination of the token shot and the bounce should see him head higher as the cycle progresses. How about another test at +5? And if he is higher, you can stop testing.
You did great today, Lori! Soon you will be addicted to green!
I hope so! Again, thank you Bhooma. Rest well tonight! I think its night time there.
Yup. 20:45. I will be around for a little longer.
@Bandit's Mom Bhooma, a question for you regarding the Temptations issue. If you do want to give some high carb is there a problem with giving a couple or three Temptations?. Susie loves them more than "life itself" and I will give her a couple every now and again when I want her to come up. I know they are really h/c. I think around 31% but not sure. I have seen others on this site use them and another person was really critical about them.
Lori, you're doing great. Congratulations on shooting the green. I KNOW how stressful it is the first few times you do it. Hope Max doesn't have another asthma attack.
The reason that high carble kibble (and Temptation treats fall in dry food/kibble category) are not recommended to boost low numbers is because they "stay in the system" longer. The view is that they do not wear off as quickly as high carb wet food or honey/karo (which are in and out within 2 hours). So you don't know if the BG is staying up on its own or if it's being propped up by the treats/dry food and therefore when to stop testing.
Makes sense. I never think of them being kibble but they are. Poor Susie. Sometimes the only way to get her out from underneath my bed is to bribe her with them. Then I will withhold them. She is going to stop trusting me.
I know. That's why they are called kitty crack or cat cocaine! There isn't any low carb/freeze dried treat that she likes?
Thank you Summer. It was stressful but Bhooma was great at keeping me calm. Bhooma he’s up to 205 so I guess he’s bouncing.
Yes he is. You can stop testing till PMPS.
And his new dose is 9.5U after the reduction.
Took Max to vet at AMPS +7 for asthma symptoms. We had been trying to avoid the Flovent inhaler if possible and were just using the Albuterol inhaler for rescue, but vet says since two attacks in one week it's time to restart the Flovent. This is the time of year when we typically start to have a problem but now we have diabetes on top of that. We will see how it affects his BG and adjust insulin as needed but he has to have the Flovent. Vet was impressed on how the hypo treatment was handled this morning. Thanks @Bandit's Mom! He also says that it very well could be possible that the asthma was triggered by his low BG. Max is doing well now except for well...the bounce. Getting ready to check PMPS.
PMPS 404, but with the bounce, token shot and just getting back from vet visit just a little while ago, to be expected I guess. Trying to stay positive. We will get back on track. I hate it for Max but this all has been a learning experience today. Hopefully somebody we all know and love will behave tonight so I can sleep. Prayers for my kitty boy Max.
@Margaret (and Pearl) what do you think about this. Does the asthma attack before dropping low? You’re the expert.
Oh my goodness. Greens are addicting!
@Margaret (and Pearl) can you help? I hope you are still checking in even though Pearl went OTJ!!!
Yay for Pearl!!!
Hi Lori @Max & Lori !! Thanks for your well-wishes for Pearl!
You don't have to be afraid of the Flovent or Albuterol in terms of BG. It actually did ZERO to affect Pearl's BG. The culprit is the oral steroid Pred, that's what will affect the BG.
The inhaled steroids are localized to the lungs in terms of their effects. I think I mentioned this before in an earlier post, but if you are worried about Max and how he may respond to the inhalers, I can help you run some tests with inhaler plus BG to determine. I believe there won't be an affect.
The problem is the asthma attacks - these are what skyrocket the BG (and with Pearl and just a slight small attack, this can still elevate her BG for up to 5-6 hours afterwards). So, if you give the Albuterol in those moments (which you should), you canNOT say that the Albuterol is raising the BG, since the ATTACK is raising the BG.
The Flovent - I would suggest doing as is the normal treatment for asthma and start giving it around the clock every 12 hours (year-round for Pearl, this is how we achieved consistency knowing what was going on with her lungs and with her BGs). You need ot give this time to start working. Once you've been on it for awhile, I can help you with the test. But again - I truly believe that Pearl would not be where she is now, successfully in remission, if I hadn't followed what needed to be done to control the asthma inflammation.
At the most very basic - your cat needs to breathe. Even without frequent attacks, asthma is chronic lung inflammation. Inflammation leads to higher BGs and higher susceptibility for the asthma to progress over time and also lead to more attacks over time. This is the most basic. I vote to do all you need for the asthma. The insulin for the FD can be adjusted. But again, I believe that you will find over time (and I can help you with this), that the inhaled steroids will not be a detriment to Max's FD progress - if anything, they will help you find the right balance of everything for him to live a successful life
PS - as far as the low BG triggering the asthma attack, the only possible correlation I can see to this is Max's body being unused to the low BG numbers, and freaking out. The freak out inside could potentially cause the asthma attack - but Pearl never had that. I will say that as Max gets USED to the lower BGs in normal range, IF the attacks keep happening in conjunction then, I will have to ask more questions.
Please ping me or tag me anytime. I can help you. Thank you @Suzanne & Darcy for tagging me on this Friday post!
Thank you so much Margaret for that wonderful information. Max still is still struggling a little. No wheezing that I can hear but he has coughed a couple of times and his respirations are faster. He always flares up in the fall and winter months. I have just started back with the Flovent a couple of days ago and I’ve used the albuterol both times he had the coughing episodes. He does seem to be a little better. I was worried about the steroid in the Flovent because he had a very bad experience with Tresaderm ear drops recently and we had to switch to a non-steroid ear drop. His glucose went over 500, which some of that was from the infection itself I’m sure. Like you said, asthma itself will cause elevated glucose. His breathing has to take priority anyway so we will adjust after we see what happens. I would be interested in your testing experiment though whenever I can get him stabilized. I am so proud of you and Pearl! Y’all are an inspiration to Max and me!!! The things we do for our cats. Some of my family and friends think I have lost my mind because of all the effort and money I am putting into taking care of Max but it is what it is. I don’t feel the slightest bit of guilt for taking care of my little buddy. He’s gotten me through some tough times in my life. Anyway thank you so much for the encouragement, the information, and your generous offer for guidance.
I think the bit of wheezing can also affect the BG - not sure if you are noticing that with Max? Any constriction or challenge Pearl had to her breathing I saw affected in her BG. I actually started giving the Albuterol a bit more liberally - whenever the more "loud" breathing would start. I think this has helped over time prevent it to progressing to full-fledged attacks.
I want Pearl to be an inspiration - so thank you! If she can do it, Max can do it too. And BTW I have heard that Tresaderm ear drops can increase BG, also. It's something about the nature of the steroid and how it is absorbed.
Yes please don't be afraid of the Flovent. And you've got a support in me and Pearl to figure out how to do this all successfully, so don't fear. It IS possible to do proper asthma treatment AND get the BG under control so that they both hum along synchronously!
Sounds good and yes we will do the test when Max has been on the Flovent regularly for awhile and his BG is more predictable. In the meantime, if you start to panic thinking the Flovent is messings things up, please tag me so I can help you walk through it and stay on that Flovent.
Will do! Thanks again!