Stalling, please help?

[Joy W]

Hi folk, first post, no idea if I am doing this right. Minerva is my sugarcat, and tonight at her pmps she was 7.7 (138.6). I have not fed her, and tested every half hour since, and she is now at 9.4 (169.2) at +14ish, with every test being higher.

She is starving and getting quite insistent that her dinner, which is now over 2 hours late, is served immediately, and I don't want to stop her eating much longer. Also I need to go to sleep soon, it it 10.40pm here and I am dead on my feet.

She is on Lantus 1 unit twice a day at the moment but has had a bit of a tumultous history including a couple of periods of sudden drops for a couple of days and then going back, and has only been on Lantus twice a day for a fortnight (prior was once a day). Her SS is only partly completed as I only just started back filling it today.

I am not sure what to do right now: I need to feed her, and then dose her with... something? Nothing?

 

[JaxBenji]

Hi! Sorry no one responded. Does Minerva have any history of ketones / DKA?

In any case, I would get some urine ketone strips (I'm not sure where you are located...NZ? but most people can find the ketone strips at the pharmacy) to test for ketones, especially if you skip. Ketones can build up quickly.

I know you said you are working on her SS, but if you get it updated (especially dosing for the past two weeks), that would be ideal - this would let those with more experience help give dosing advice. Ideally, you find a dose of lantus you can give twice a day (12-hours apart).

If I'm right about you being in NZ (best guess on your time noted), @Bron and Sheba (GA) are in Australia and may be able to stop by too

 

[Joy W]

Hi, yes, New Zealand! I guess I am just well out of time zone for a response, but we are kind of used to that here in NZ. I fed her and skipped because I was not confident to shoot and am updating SS now as best I can with data from the glucometer. She has no history of ketones to my knowledge and no DKA - last ketone test was at the vets about 3 weeks ago where she conveniently peed in her cage just as we were about to leave so they quickly syringed it up and tested it on the spot and there was nothing; her highs aren't super high (I don't think?) and my vet said she considers her "regulated". It may not have been the best course but it is what it is! Thank you!

 

[Bandit's Mom]

Hi Joy, I am in India and am usually online (when's its night in the US).Sorry I didn't see this! Please tag me the next time

Next time you get a number that you aren't comfortable shooting, stall without feeding and test in half an hour. If the next test is higher it means her numbers are heading higher and you can give her the shot - provided you can monitor. It looks like you were waiting for her number to rise above 200mg/dl (11 mmol/l) to shoot?

If you post in the Lantus / Basaglar (glargine) and Levemir (detemir) forum, you will get more eyes from experienced Lantus users on your posts.

In addition to updating your Spreadsheet, it would be a big help to us if you can set-up your signature? It's basically a summary of the information we need about your cat to give you advice. The spreadsheet and signature are the things we look at when asked for advice. It saves us asking you the same questions again and again especially when the question is time critical like stalling or low numbers. It also saves you the effort of giving us the information every time you post!

Here's how you can set-up your Signature:

• In the Menu, under your user name, click on Signature.

• Add info we need to help you:
  • Caregiver & kitty's name
  • DX: Date
  • Name of Insulin (do not include dose or frequency)
  • Name of your meter
  • Diet: "LC wet" or "dry food" or "combo"
  • Dosing: TR or SLGS or Custom (if applicable)
  • DKA or other recent health issue (if applicable)
  • Acro, IAA, or Cushings (if applicable)
  • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
  • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
• There is a limit of two lines. You may separate info with commas, dashes, | etc.
• Be sure to click the 'Save Changes' button at the bottom.

 

[JaxBenji]

Thanks @Bandit's Mom

Hi, yes, New Zealand! I guess I am just well out of time zone for a response, but we are kind of used to that here in NZ. I fed her and skipped because I was not confident to shoot and am updating SS now as best I can with data from the glucometer. She has no history of ketones to my knowledge and no DKA - last ketone test was at the vets about 3 weeks ago where she conveniently peed in her cage just as we were about to leave so they quickly syringed it up and tested it on the spot and there was nothing; her highs aren't super high (I don't think?) and my vet said she considers her "regulated". It may not have been the best course but it is what it is! Thank you!

The board does have people here all over the world, just need to connect you all together so they keep an eye out Also, I'm not sure if @katy and mo (GA) still checks the board but she's in NZ too though her kitty crossed the rainbow bridge.

It's excellent you are home testing and I would pick up ketones strips next time you are at the pharmacy so you can test at home too (FWIW, I knew nothing about ketones until Jax was dx with diabetes and then I started testing him and eventually got a blood ketone meter for ease of testing; some info on ketones can be found here-link). I also always like to keep in mind Lantus is dosed on how low it takes the cat (the nadir) versus how high the cat is (your higher values are often your preeshot values while the nadir is somewhere mid cycle).

Hugs to you and Minerva

 

[Ann & Sister]

Thanks @Bandit's Mom
I also always like to keep in mind Lantus is dosed on how low it takes the cat (the nadir) versus how high the cat is (your higher values are often your preeshot values while the nadir is somewhere mid cycle)

Just trying to understand "stalling" in case it comes up for me. If using SLGS method and AMPS is under 90, I understand you do not shoot. That was recently explained to me. This protocol is based on the morning BG rather than a nadir, right? If I decided to stall without feeding breakfast, and say the BG climbed to 92, I could shoot then? Even if that was 2 hours later? And if I shot LATE, how is the evening shot adjusted timewise? And to further complicate my question , could I also choose to skip the AM shot and simply feed when kitty is so hungry? And then try again after testing in PM?
Thanks bunches,
Ann

 

[JaxBenji]

Just trying to understand "stalling" in case it comes up for me. If using SLGS method and AMPS is under 90, I understand you do not shoot. That was recently explained to me. This protocol is based on the morning BG rather than a nadir, right? If I decided to stall without feeding breakfast, and say the BG climbed to 92, I could shoot then? Even if that was 2 hours later? And if I shot LATE, how is the evening shot adjusted timewise? And to further complicate my question , could I also choose to skip the AM shot and simply feed when kitty is so hungry? And then try again after testing in PM?
Thanks bunches,
Ann

I responded on Ann's post from today - https://www.felinediabetes.com/FDMB/threads/curve-schedule.249592/