Suzanne & Darcy
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I am very glad you reduced but she still went into the low low numbers.
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New (continued) Monica & Mia
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Suzanne & Darcy
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How’s it going, Monica? Did you start the Lantus yet? Please keep Mia’s spreadsheet updated. I’m concerned about all the lime green numbers. After consulting with one of our moderators, I was thinking — if Mia does not have ketones — you could try a cycle with no insulin and see how she does. But you probably already started the Lantus, which is perfectly fine. Keep testing - beginning at +2.
@Suzanne & Darcy So far so good it seems like! She got her first dose of Lantus this morning, currently giving 7.45am/pm (GMT+2), been testing every 2 hours and just tested her BG at +6 and still no lime green numbers and from the looks of it the lowest was at +4.
Suzanne & Darcy
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I’m thrilled to see this beautiful cycle so far today! It will take a few days at least for us to see the full effect of the dose, but what a great start!
Suzanne & Darcy
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It actually looks like her nadir was at +6. Mia must have read the Lantus manual! 
@Suzanne & Darcy yes I'm so happy with her numbers today! I wanted to ask infact how the "bouncing" effect is when switching insulins like this. Would the recent low numbers while on caninsulin still be affecting her and might cause higher BG than what she would have had without the bounce?
Also, before her next shot is due so I am prepared just in case. Would you say there is a no shoot number I should consider?
@Bron and Sheba (GA) @JL and Chip
Just tagging you to see if you have any advice regarding a no shoot number when testing Mia's BG before shooting?
Just tagging you to see if you have any advice regarding a no shoot number when testing Mia's BG before shooting?
Gill & George
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She is strictly on low carb wet food
Gill & George
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Ok, i haven't read all through your thread, have you discussed or decided which dosing method you are going to use with lantus?She is strictly on low carb wet food
@Gill & George not sure what you mean? She just switched from caninsulin to Lantus this morning, so she has had one Lantus dose til now, this was meant to be her second one.
I was recommended to start out with 0.25u as she was having very low numbers with caninsulin
Gill & George
Very Active Member
We haven't got data on how Mia is going to react to lantus yet, in theory once we have enough data we can shoot even green numbers. But that would not be advisable at the moment due to lack of data.
How long before you need to make a decision? I see she's at 115 at +10.
Please don't feed anything after +10 and let's see what her pmps is. We want a number that isn't influenced by food.
How long before you need to make a decision? I see she's at 115 at +10.
Please don't feed anything after +10 and let's see what her pmps is. We want a number that isn't influenced by food.
Gill & George
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What I mean is that we don't know how her body is going to react to lantus.
There are two different ways we make dosing decisions with Lantus, don't worry about that now if it's not something that you have given much consideration..
Do you think you could get a +11.
It will help us see where she is heading when you get the pmps and that will help us make a decision on whether bro shoot or not.
@Gill & George
She was due for her dose 1 hour ago now. Posted here and on the Facebook group for advice due to her low preshot BG number, and have now been recommended to skip this dose. I did not feed 2 hours before her preshot BG test.
Gill & George
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Great good decision
Gill & George
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Even though you skipped a shot it would be good to get a +1, as it might give us a clue as to what might have happened if you had shot.
What was her pmbg? I thought you were still waiting for advice on whether to shoot or not as as wasn't updated.
Put the pmbg value and NS in the dose so we know what's gone on.
Nice first cycle.
ETA
As Mia has had dka and you've skipped an insulin dose please make sure you monitor for ketones.
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@Gill & GeorgeEven though you skipped a shot it would be good to get a +1, as it might give us a clue as to what might have happened if you had shot.
What was her pmbg? I thought you were still waiting for advice on whether to shoot or not as as wasn't updated.
Put the pmbg value and NS in the dose so we know what's gone on.
Nice first cycle.
ETA
As Mia has had dka and you've skipped an insulin dose please make sure you monitor for ketones.
As is a +1 of what was supposed to be her shot time? Or +1 from when she gets her next dose in the morning? I got the advice I needed on the FB group, and just had to go with it since 1 hour had already passed since she was supposed to have her shot.
Will be sure to monitor for ketones, we have testing strips at home
JL and Chip
Very Active Member
I would test a couple of times after the skipped shot (so between now and your next shot time tomorrow morning) just to see what happens. Be sure to document those numbers on the spreadsheet.
When a cat is producing their own insulin, after feeding you will often see an initial increase in BG followed by a decrease (as the body kicks out insulin). In a diabetic, we replace/supplement the insulin that the cat’s body isn’t providing by giving insulin shots. For a cat heading toward diet-control/remission, a skipped shot can sometimes give us a clue as to whether the cat’s own pancreas is contributing insulin.
The first Lantus shot could be providing some assistance here, and could impact the current cycle where you just skipped a shot. Or maybe not so much, since it was just the first shot and the depot hasn’t yet filled. All data is good data, so whatever tests you get in can help paint the picture as to what’s happening.
Some cats just need a switch to low-carb canned food and a short course of insulin in order to go into remission. We don’t want to rush the process, so collecting data is helpful. We can actually reduce from 0.25u to 0.1u to just a “drop” of insulin as a cat works its way down the dosing scale.
Kudos for hanging in there and being so proactive. It’s been an “interesting” journey given the Caninsulin, syringes, ketones, food and insulin changes, repeated low BG numbers, and so on. You’re doing great!
When a cat is producing their own insulin, after feeding you will often see an initial increase in BG followed by a decrease (as the body kicks out insulin). In a diabetic, we replace/supplement the insulin that the cat’s body isn’t providing by giving insulin shots. For a cat heading toward diet-control/remission, a skipped shot can sometimes give us a clue as to whether the cat’s own pancreas is contributing insulin.
The first Lantus shot could be providing some assistance here, and could impact the current cycle where you just skipped a shot. Or maybe not so much, since it was just the first shot and the depot hasn’t yet filled. All data is good data, so whatever tests you get in can help paint the picture as to what’s happening.
Some cats just need a switch to low-carb canned food and a short course of insulin in order to go into remission. We don’t want to rush the process, so collecting data is helpful. We can actually reduce from 0.25u to 0.1u to just a “drop” of insulin as a cat works its way down the dosing scale.
Kudos for hanging in there and being so proactive. It’s been an “interesting” journey given the Caninsulin, syringes, ketones, food and insulin changes, repeated low BG numbers, and so on. You’re doing great!
Gill & George
Very Active Member
Sorry wasn't clear. @JL and Chip explained it better.
Just a few checks in the cycle to see what's going on and to help with decisions in the morning.
@JL and Chip thanks for the detailed reply!
As you see, I ended up skipping after advice I got on the Facebook group. And have been testing every 2 hours since then all night. She has stayed in the blue numbers, with her most recent BG being at 9.6 an hour ago.
She is now due for her next shot in an hour and I'm not sure again about what I should do. Should I shoot with a reduced dose? Like you said, that we can reduce to 0.1u?
Bron and Sheba (GA)
Very Active Member
I’m just seeing this. And looking at the SS I see you gave 0.1 unit Lantus. It will be interesting to see how she goes in this cycle.
Did you test for ketones?
Is she eating OK?
Did you test for ketones?
Is she eating OK?
Hi! Yes I decided to go with 0.1 since @JL and Chip mentioned that in their previous post.
I haven't been able to test for ketones yet, will try to catch her on the act during the day today. And she is keeping up her eating/appetite
Suzanne & Darcy
Very Active Member
Great job with all that testing. After the no shot, we can see she’s not ready to go off of insulin yet. She’s doing well today. Did you have any trouble drawing the .1 dose?
Suzanne & Darcy
Very Active Member
@Suzanne & Darcy I agree, even though I was super happy to see her numbers didn't reach yellow numbers
I kind of just eyeballed it, but I would say the plunger was closer to the 0.0 line than on the photo, so maybe she got even less than 0.1u?For her evening shot, what are your suggestions/recommendations? Was I right to not shoot yesterday evening given her pre shot number? And would you agree that lowering to 0.1u this morning was the right move?
Just want to be prepared in how to handle her BG when testing pre shot, to know if I should lower the dose, not shoot or wait for a specific time to see if the BG goes up before again making a choice between shooting/not shooting/lowering
Suzanne & Darcy
Very Active Member
I agree. I was happy to see her stay in all blue after the skipped shot. Well… let’s see how the rest of the cycle goes today. She may be a little lower at +6. I see the nice green +4.
I think we gained some valuable information last night. One thing we learned besides that she needs a little insulin support is that (in my opinion) it would have been safe to give her at least some insulin. I am fine with the skipped dose from last night, but I think now if she has a similar number we can at least try the .1 unit dose as long as you will be able to monitor the cycle and manage any numbers that are too low with food/carbs.
If today’s cycle continues to be good and she doesn’t go up into yellow, I would continue to give the .1 unit dose. We will soon know if she needs more than that because her numbers will start creeping up. We do not need to rush the process … no hurry at all since she just started. I am excited to see how the rest of today goes!
I think we gained some valuable information last night. One thing we learned besides that she needs a little insulin support is that (in my opinion) it would have been safe to give her at least some insulin. I am fine with the skipped dose from last night, but I think now if she has a similar number we can at least try the .1 unit dose as long as you will be able to monitor the cycle and manage any numbers that are too low with food/carbs.
If today’s cycle continues to be good and she doesn’t go up into yellow, I would continue to give the .1 unit dose. We will soon know if she needs more than that because her numbers will start creeping up. We do not need to rush the process … no hurry at all since she just started. I am excited to see how the rest of today goes!
JL and Chip
Very Active Member
Given the circumstances, I would continue measuring the 0.1u the same way you did this morning.
Nice cycle so far.
Nice cycle so far.
Gill & George
Very Active Member
Nice cycle so far, I agree with the others let's see where the 0.1 u. Takes her. With lantus you often don't see the full effect of the dose until the deposit fills and stabilises, so we will ideally try to stick to the 0.1u unless she drops too low or if she starts to develop ketones or if you see signs DKA. (Lethargy, loss of appetite), please advise us immediately if you have any concerns that Mia is acting off in any way.
What we are looking for in terms of cycles is all green, she's not far off, paws crossed she works the juice when the deposit fills.
What we are looking for in terms of cycles is all green, she's not far off, paws crossed she works the juice when the deposit fills.
@Suzanne & Darcy seems like her lowest today was at +4 unlike the first dose she got where it was lowest at +6.
Will stick with the 0.1u dose like I gave her this morning if her number is similar to this morning and the BG she had yesterday when we skipped her shot. But, does this mean you think I should increase if it's more than let's say 10 when testing pre shot?
@JL and Chip Is there a number for the preshot BG where you would think I should go back to 0.25u? Or should I stick with 0.1u even if she goes up to 10-15?
Suzanne & Darcy
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Almost 2 hours until shot time?
Suzanne & Darcy
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If she is in yellow I would go back to .25. If it’s borderline like 190, I would shoot .25. But I would then consider.25 as her dose going forward and would actually shoot a 110 (like last night) with .25, knowing that if I can monitor her cycle that I am in total control because I can test, feed and give carbs as necessary to bring numbers up.
Suzanne & Darcy
Very Active Member
And if I saw anything 50-99 I would be so happy.
Suzanne & Darcy
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So I was just thinking I should explain. With her very small dose and her numbers, you are already in the position of following TR (instead of SLGS) because with SLGS a reduction is earned when the cat drops below 90. That would not be good for Mia right now when it looks like she may have a good possibility of going into remission. For example, she would have earned a reduction today with the 85 at +4. That would not help her to stay in the “healing green” numbers, as we like to call them around here. So with Tight Regulation (TR) protocol, we like to see lower numbers but keep the cat at 50 or above — mostly green or very low blues is good (hopefully under 120.)
@Suzanne & Darcy Just updated the SS with her +10 BG reading which was at 6.6. a little less than 2 hours until her next shot now
Ok so anything 10.6 or higher I go back to 0.25u, and anything under I stick with the 0.1u? (From my calculations, 190 like you mentioned translates to 10.6)
@Suzanne & Darcy Just to be sure, IF I end up seeing these numbers at her preshot BG, I still give 0.1u?
Suzanne & Darcy
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That will probably be okay although you can shoot green numbers with TR but it’s early days now so if you feel more comfortable with that it’s fine. We will be gathering data on how she does. It also occurs to me that you mentioned her dose this morning may have been a little less than the photo. So if you draw a 0.1 dose that has another drop in it that could make a difference. I would practice with the syringe and see how many actual drops are in my 0.1 dose and in my .25 dose and I would make sure I could draw a consistent dose each time. You know how to do it with water.
@Suzanne & Darcy thank you so much for explaining this! Have seen these mentioned a couple of times now but haven't had the time to really read about the two options/protocols. Makes sense the way you explain it
@Suzanne & Darcy Could you clarify what exactly you mean? What would be ok and feel more comfortable with what? Sorry about all the questions, just want to be sure I understand your suggestions
Suzanne & Darcy
Very Active Member
Do you mean if she was between 50 and 99 for a preshot number. No. If she had a 50 (2.8) at preshot, I would skip the dose. Let’s see where she is at preshot time.
With TR, experienced members who have lots of data on their cats will shoot anything above 50 — but we are certainly not at that point! What I was saying was that — if I saw some nice green numbers during the middle part of the cycle I would be pleased (as long as she didn’t drop below 50). I was NOT referring to a 50 preshot number.
But I don’t think Mia is going to be that low tonight. Don’t stress (I know; it’s hard.)
Suzanne & Darcy
Very Active Member
One hour and a half until shot time? I am just asking because I want to set an alarm on my phone so I can be around at shot time and you won’t be alone. It’s 12:15 p.m. now my time so that would be 1:45 my time which is 7:45 your time.
Suzanne & Darcy
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Hopefully you gave her a small snack just a little before the two hour window. Her numbers were low enough that it would have been okay.
Suzanne & Darcy
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What I said above about the 0.1 dose? I am just kind of wondering (because you said you thought your dose this morning was a little closer to the zero mark) exactly how much insulin she got this morning. I wonder if it was one drop or two. It could make a difference. If we knew how many drops were in the doses, we could make better decisions for this evening. It should be more than one drop because there is such a thing as a single drop dose (but people draw their doses differently so I cannot say exactly how many drops yours will be.) I would like to see her at a consistent dose - a dose where you can shoot it consistently and we don’t have to be wondering how much to shoot each time. It’s less stress on you as well.
Suzanne & Darcy
Very Active Member
As for what I said about you being more comfortable — if that’s what you wanted to know — what I mean is that I am certainly not going to push you to shoot .25 tonight if you are really uncomfortable with doing so (and we may not even be considering that in an hour anyway!) I want to decide upon a dose you can feel comfortable shooting based on the data we have so far. We can talk through it at shot time. We have choices and can reason through them. We will be able to do this at shot time.
Oh that would be amazing! Thank you so much @Suzanne & Darcy! That is correct, I am shooting at 7.45 am and pm in the GMT+2 time zone
Suzanne & Darcy
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I will be there well… I will be here!
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@Suzanne & Darcy I was just wondering what you were referring to when you said this: " That will probably be okay although you can shoot green numbers with TR but it’s early days now so if you feel more comfortable with that it’s fine" which was your reply to me writing this: "Ok so anything 10.6 or higher I go back to 0.25u, and anything under I stick with the 0.1u? (From my calculations, 190 like you mentioned translates to 10.6)"
@Suzanne & Darcy just tested and it's 8.1. So I guess I stick to 0.1u?
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