Sept. 3rd Blaze and Paola

Discussion in 'Lantus / Levemir / Biosimilars' started by Blaze and Paola, Sep 3, 2020.

  1. Blaze and Paola

    Blaze and Paola Well-Known Member

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  2. Critter Mom

    Critter Mom Well-Known Member

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    Morning, Paola. :)

    I'm glad all went well overnight, and I hope you managed to get some rest for yourself. Are your little ones eating better today?

    May I enquire why 0.5IU today? I ask because Blaze earned a dose reduction (down to 0.25IU) when you gave him the 0.5IU the night before last.


    Mogs
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  3. Blaze and Paola

    Blaze and Paola Well-Known Member

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    Good morning Mogs,
    yes, I did sleep a little more last night even though in segments...
    When I look at his chart, I see that when I give him 0.25, he stays in yellow mostly...isn't it better to be green?
    Maybe with the 0.50 Units he stay more in the green?
     
  4. Blaze and Paola

    Blaze and Paola Well-Known Member

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    Just trying to understand...
     
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  5. Blaze and Paola

    Blaze and Paola Well-Known Member

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    He is eating a lot this morning, both wet and dry
     
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  6. Critter Mom

    Critter Mom Well-Known Member

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    Here's a little more info on how Lantus works.

    Lantus is what's known as a depot insulin. With each successive dose, Lantus builds up a little 'tank' of insulin in the body (the depot). It takes at least 6 cycles on a given dose before you can properly gauge the dose's safety and efficacy.

    We know from your testing earlier in the week (PM cycle 31 Aug, AM & PM cycles 1 Sep) that after only 3 cycles the 0.5IU dose was already taking Blaze's BG levels too low.

    You gave approximately 0.25IU Lantus last night. You need to hold that dose for now to allow the depot to fill. BG levels may start in the yellows but when the depot is properly established we would hope to see improvement in those numbers. It can take a few days for a new dose to settle.


    Mogs
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  7. Critter Mom

    Critter Mom Well-Known Member

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    That's the sort of news I like to hear. Keep it up, Blaze! :cat:

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  8. Critter Mom

    Critter Mom Well-Known Member

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    Did the above explanation help?

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  9. Blaze and Paola

    Blaze and Paola Well-Known Member

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    0.25 it is! He ate!!! Yay
     
  10. Blaze and Paola

    Blaze and Paola Well-Known Member

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    100% thank you
     
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  11. Blaze and Paola

    Blaze and Paola Well-Known Member

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    Last night I shot at 9 pm...should i wait another 15 min before shooting? He just finished eating
     
  12. Critter Mom

    Critter Mom Well-Known Member

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    Cool! :cool:

    I am genuinely thrilled Blaze has his appetite back.

    You can move the shot time back each day as follows:

    15 minutes on both AM and PM cycles

    - OR -

    30 minutes on either AM or PM cycle (not both)

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  13. Blaze and Paola

    Blaze and Paola Well-Known Member

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    I will wait for 8:45 to work my way back. Your explanations are incredible thank you
     
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  14. Blaze and Paola

    Blaze and Paola Well-Known Member

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    Me too i was so worried yesterday...look...
     

    Attached Files:

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  15. Blaze and Paola

    Blaze and Paola Well-Known Member

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    Staff meeting starting soon, gonna be back in 30 min. I will be late for it so I can shoot Blz right at the time the meeting start....8:45. And....I don't care :):D
     
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  16. Critter Mom

    Critter Mom Well-Known Member

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    If you look at the top of this board you'll find a lot of 'sticky' information posts which you can read through to learn more about how Lantus works and how it is dosed.

    There are two dosing methods advocated on FDMB: Tight Regulation (TR) and Start Low, Go Slow (SLGS). In both protocols doses are adjusted in small increments. In SLGS doses are held for longer than in TR and also the BG level at which dose reductions are earned is higher (50/2.8 for TR, 90/5.0 for SLGS). Should you opt to start on SLGS you can always switch to TR at a later time if you wish. You can find out more about the protocols in this sticky post:

    https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/

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  17. Critter Mom

    Critter Mom Well-Known Member

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    Magic! :D

    Eat your fudz, little kitties. :cat:
     
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  18. Critter Mom

    Critter Mom Well-Known Member

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    Now that's the voice of a woman with immaculate prioritization skills. LOL! :D

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  19. Blaze and Paola

    Blaze and Paola Well-Known Member

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    I actually joined the meeting late, turned off my mic and cam and cuddled the boys while... "listening" It was a super short one, now I can start my day. Thank you for the link Mogs, I will read through today.
     
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  20. tiffmaxee

    tiffmaxee Well-Known Member

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    Hi. Great to see the boys eating. Hope it continues. Remember Lantus is dosed on how LOW it takes the cat, not on the preshots. When you read the yellow sticky on methods when feeding dry you follow SLGS. Doses are held for a week and then re-evaluated based on tge nadir, the lowest point. Even if you stopped dry I would follow that method because you won’t be home to monitor. Some follow TR and work full time but I couldn’t. You can read it and see what you think.
     
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  21. Critter Mom

    Critter Mom Well-Known Member

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    Morning, Elise! :)

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  22. tiffmaxee

    tiffmaxee Well-Known Member

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    Morning. I hope you slept.
     
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  23. Critter Mom

    Critter Mom Well-Known Member

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    Took a while to come in to land but eventually I did, thank God. Brain and body both very drained after all the low runs over the last few days.

    Yourself?

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  24. Blaze and Paola

    Blaze and Paola Well-Known Member

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    Girls,
    I am reading through the link you sent.
    I am not sure if it is because I have been sleep deprived or I might have a learning disability but reading through is very overwhelming and hard to understand for me.
    I am unsure if I am on a TR or SLGS right now. Does one method require less BG testing than the other?
    My cats love their dry food...their previous diet was basically based on dry with exception of morning wet food. When I completely removed it, I could tell they were looking for it. Now that i am giving them some, they are less stressed (stopped looking for the upstairs bowls constantly, stopped wondering around looking for it etc...).
    I am not giving them a lot but I know that they enjoy it.
    On the document I read that it is best to give them only wet...but it is too much for my cats. I know them and they won't be able to adapt without dry. Am I going against the protocols?
    The vet had told me absolutely no snacking in between feeding but my cats were grazers and they didn't adapt well to that either. I tried at first but they were begging and crying.
    On the doc I read it's ok for the cats to eat a little bit during the day too. I noticed Ash is a happier guy if he knows he can go eat a few pieces of dry during the day here and there and so is Blz.
    As far as the vet, the last time I went and met the nicer vet, I was still on the 0.5 dose and that is what she wrote on Blz's medical log.
    I have lowered to 0.25 but they don't know that yet. When they ask for a curve I will have to do it based on 0.25, right?
    I know my cats and the extreme changes of the past 9 days have been a lot for them.
    I hope I can keep some sort of the routine they were used to (except for what I am feeding them now), while maintaining Blz in check and regulated.
    I know that I have been removing all foods 3 hours before dinner and overnight there is no food out at all.
    Am I doing this ok, should I change something.
    I am sorry for the long email...i just want to do what's best for my babies and its been very overwhelming.
    Thank you for being there for me...
     
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  25. Blaze and Paola

    Blaze and Paola Well-Known Member

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    Last wondering thought in my head...
    Is it possible for people who work long days and are away from home for most of the day to still keep their sugar kitties safe?
     
  26. Blaze and Paola

    Blaze and Paola Well-Known Member

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    The reason while i am asking (last thought I wrote above) is because I have looked at some your cats spreadsheets and I see that there is a lot of testing that goes on overnight.
    I have been able, until now, to stay up, test multiple times in the middle of the night...but when school starts and I have to report to work in the mornings, if I don't sleep properly, I won't make it.
    I am very worried about it all, considering i am back full time next Tues.
     
  27. Critter Mom

    Critter Mom Well-Known Member

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    That's right, Paola. You feed as normal, too.

    The idea is that the curve gives a snapshot of how Blaze's BG is running on a normal day.

    You can leave food down until 2 hours before the preshot check is due if you wish.

    With regard to overnight feeding, do you have the timed feeders yet?

    (Will answer some of your other questions in a little while.)


    Mogs
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  28. Critter Mom

    Critter Mom Well-Known Member

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    Yes. :) With a little time you'll be able to develop a routine that works for you and Blaze.


    Mogs
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  29. Blaze and Paola

    Blaze and Paola Well-Known Member

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    Yes I bought them!
     
  30. Blaze and Paola

    Blaze and Paola Well-Known Member

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    Dozing off...will check back in 1 hr or so..:bighug:
     
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  31. Critter Mom

    Critter Mom Well-Known Member

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    If you want to leave food out during the day while you're away and also at night. Leave the last compartment empty and set the timer to rotate 2 hrs before preshot is due. Any food left in the last-but-one compartment will be moved under the feeder cover, keeping you on schedule.

    Timed feeders are a gift from the FD gods. :)

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    Last edited: Sep 3, 2020
  32. Critter Mom

    Critter Mom Well-Known Member

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    Grab the zzzs anywhere you can, Paola. :)

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  33. Critter Mom

    Critter Mom Well-Known Member

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    That's advice more applicable to intermediate-acting insulins like Vetsulin/Caninsulin and Novolin N than Lantus. When using the intermediates, the cat needs a really substantial meal and needs to wait a little while before it's safe to give insulin and, unlike Lantus, the insulin dose peters out well before the end of the cycle.

    Your vet will be able to see and understand from Blaze's BG test results that the 0.5IU was taking him a little too low and that you reduced the dose for safety.

    There is an absolute wall of information in the sticky posts but it will gradually make more sense as you become more experienced. Also, when the time comes to review each dose you can refer back to the stickies each time to determine what to do. In the meantime we'll help you to get to grips with the fundamentals.

    Technically no. The Roomp-Rand TR protocol recommends that a minimum of three tests must be done per day: AMPS, PMPS, and one mid-cycle test on either the AM or PM cycle (preferably alternating between the two on different days to give better visibility of what's happening during the day and at night). ETA: SLGS would need the same minimum number of tests.

    As you have observed from other kitties' spreadsheets, in practice TR can see cats running in lower BG levels and therefore additional testing is necessary when they get a little too close to the hypo threshold. Note that following SLGS may also see a cat having a run of low numbers which needs closer monitoring but because dose reductions are taken at a higher BG level the likelihood of a cat getting that low is reduced.

    Management of feline diabetes needs to be manageable for the caregiver, the cat, and also other cats in the household need to be taken into consideration. Everyone's situation is different and you will be able to work out a treatment regimen for Blaze, a diet and feeding schedule that is right for your cats, and a routine that is right for all of you. This is all new and overwhelming at the moment, but with a little time and experimentation you'll fathom out what works for the three of you. We'll do what we can to help you with the teething problems. :)


    Mogs
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    Last edited: Sep 3, 2020
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  34. Blaze and Paola

    Blaze and Paola Well-Known Member

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    Thank you so much for th explanations Mogs, I am starting to get it little by little. Still feel like i have been hit by a truck but working through it. Thank you for everything ❤
     
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  35. Lisa & Oberon

    Lisa & Oberon Well-Known Member

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    Hi Paola, just wanted to say that I'm relatively new, too, and I know how overwhelming it seems at first. Hang in there! Take your time, read the stickies, read them again later as you go, and keep posting and asking questions here. You can also learn a lot by reading other people's daily posts to see how they handle situations you haven't encountered yet. This group is amazing and there's a wealth of information and support available. You can do it!
     
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  36. Blaze and Paola

    Blaze and Paola Well-Known Member

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    Thank you, i will start reading the stickies, there so much info. In these past days I felt desperation to have answers and to have someone to tell me what to do. This board is a gift from above.
    As soon as I feel I am a little more grounded, I will take a big breath and start reading and re reading. Thank you for your encouragement
     
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  37. Critter Mom

    Critter Mom Well-Known Member

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    Nice little paddle in the lagoon at +5 today, I see. :)

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  38. Blaze and Paola

    Blaze and Paola Well-Known Member

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    Yes we are paddling our way :))
     
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  39. Blaze and Paola

    Blaze and Paola Well-Known Member

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    He slept a lot today and so did I...more than 3 hours (me). I just came back home from Walmart i got some school supplies. Gonna test him.
     
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  40. Critter Mom

    Critter Mom Well-Known Member

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    I'm very glad to hear you got some decent kip, Paola. :)

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  41. Blaze and Paola

    Blaze and Paola Well-Known Member

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    Blaze was faster than me and went and ate some dry...gonna test in a little while.
     
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  42. Blaze and Paola

    Blaze and Paola Well-Known Member

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    Much needed... :)
     
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  43. tiffmaxee

    tiffmaxee Well-Known Member

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    Nice flat cycle. I’m glad he’s eating. Sometimes a flat yellow is followed by an active one.
     
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  44. Blaze and Paola

    Blaze and Paola Well-Known Member

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    Yes, he had some dry a couple of hours ago and then the automatic feeder turned into an empty bowl at 5, so that I have plenty of time for them to be hungry again, especially Blazey Boy. Fingers crossed it will work.
    I will set up the feeder to be open with a little bit of dry food until 5 AM then I will program it to close so that we will be hungry again for breakie.
    Blaze is being very conservative in his eating, but at least he is eating.
    I have some good news...
    Ash's test results came back....all GREAT! The chemo is working, his blood count is normal, his glucose is perfect, his organs are functioning great.
    So I don't feel as bad now considering they both ate the same all these years.
     
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  45. Blaze and Paola

    Blaze and Paola Well-Known Member

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    He just went to the feeder...he is trying to eat out of the empty bowl...he probably smells the food from the nearby covered spot...he is trying to open it...I hope he makes it another 2 hours
     
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  46. Critter Mom

    Critter Mom Well-Known Member

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    I've tried a fair number of feeders and the Petsafe 5 ranked very highly in the burgle-proof department. :)

    Wonderful news about Ash! Delighted for the pair of you. :cat:

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  47. tiffmaxee

    tiffmaxee Well-Known Member

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    Wonderful news! What drug is Ash on?
     
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  48. Blaze and Paola

    Blaze and Paola Well-Known Member

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    He has policythemia and is on Hydroxiuria, one pill every 3 days
     
  49. Blaze and Paola

    Blaze and Paola Well-Known Member

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    I gave the shot to Blaze but everytime I do, he moves away as soon as he feels the poke...It's hard to make sure the the liquid goes in sometimes. I have always got it in so far (looking at his levels after) but tonight I am a little doubtful. I felt the fur to feel wet but he had just gone to the fountain and the little wet I felt could have been the water...he likes to put his whole head under the fountain like he takes a shower. I hope it went in...
     
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  50. tiffmaxee

    tiffmaxee Well-Known Member

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    Been there. Done that. All of the time it got in. That’s why even when sure it’s a fur shot we never shoot again although I was tempted. ;)
     
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  51. Blaze and Paola

    Blaze and Paola Well-Known Member

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    I guess the test later on will tell...
    Does your cat jerk when u do the shot?
     
  52. tiffmaxee

    tiffmaxee Well-Known Member

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    He didn’t jerk. He was so good I was able to shoot him in the spflamk or tummy.
     
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  53. Lisa & Oberon

    Lisa & Oberon Well-Known Member

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    Oberon flinches a little sometimes, but I do it while he's eating, so he's distracted. My routine is to give the shot, run my fingers through his fur a bit, and then smell them. The Lantus has a definite odor to it, so besides the fur feeling wet I'm pretty sure I'd smell it on my hand if I missed. (But even if I did I wouldn't give more because who knows how much actually went in.)
     
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  54. Blaze and Paola

    Blaze and Paola Well-Known Member

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    I think i can try to shoot while he is eating but not yet because his eating hasn't been consistent and I don't want to spook him while he does...
    I could try giving him a treat but I have not found any low carb treats that he likes...
     
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  55. Lisa & Oberon

    Lisa & Oberon Well-Known Member

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    I've tried the freeze dried chicken and turkey and Oberon likes both of them. He went absolutely nuts for freeze dried salmon but it really stinks so I'm avoiding it for my own sake!
     
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  56. tiffmaxee

    tiffmaxee Well-Known Member

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    My two go nuts for freeze dried lamb. One likes shrimp. Tge other couldn’t figure out it was food.
     
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  57. Blaze and Paola

    Blaze and Paola Well-Known Member

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    I have tried those...both my cats look at it weird and try to play with the pieces...I tried all flavors. I should eat them now to avoid wasting the money lol
     
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  58. Critter Mom

    Critter Mom Well-Known Member

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    If Blaze and Ash won't eat the treats, perhaps a local cat shelter might appreciate them. :)


    Mogs
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