? Wilson Post Hypo dose advice

Discussion in 'Lantus / Levemir / Biosimilars' started by Tanya & Wilson, Feb 21, 2018.

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  1. Tanya & Wilson

    Tanya & Wilson Member

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    Jan 25, 2018
  2. tiffmaxee

    tiffmaxee Well-Known Member

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    Do you have supplies? Can younmonitor? If so I would shoot the new reduced dose of 2.25. If not you could skip. You could not feed and stall to see if he’s coming up too
     
  3. Tanya & Wilson

    Tanya & Wilson Member

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    Jan 25, 2018
    He is eating now but I have to leave in 15mins wich is shot time. I cannot monitor but will be back around +2 for 5 mins so can check on him then. I am too scared to give him a shot after such low numbers last night. I expected a slight bounce and a higher number this morning.
     
  4. Tanya & Wilson

    Tanya & Wilson Member

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    Jan 25, 2018
    Tested again 25 minutes later and he's dropped to 8.9 so missing his shot this morning to be safe.
     
  5. Kris & Teasel

    Kris & Teasel Well-Known Member

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    You have to be comfortable with any action you take. This is the right call for you after last night.
     
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  6. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    After the hypo last night and the food change my thought would be to skip to drain the depot. It tooke a lot of honey and gravy to get the numbers up last night and you won't be home to monitor today,.


    With the recent change from dry food to raw & low carb wet Wilson's insulin needs may have reduced greatly. With a no shot while you are at work it allows the depot to drain and gives you peace of mind while you are away. After the hypo last night the numbers usually would be much higher than they were this morning. Check when you get home from work and post again with the readings. Since you are in Australia there may not be as many people up at PM shot time who know the whole story.


    ETA The decision will be what to give Wilson for his PM shot. If you can post when you get a test once you are home from work you can get some opinions of where to go with the dosing. Personally I feel that after the hypo and with a lower AMPS reading that 2.25 unit may be too much, especially with the recent food change.
     
    Last edited: Feb 21, 2018
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  7. tiffmaxee

    tiffmaxee Well-Known Member

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    Skipping was the right call. I would never shoot when I had to leave Max and he was low for him. When was the food change?
     
  8. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    She started changing Feb 8 and then again Feb 12 . You can see the numbers have started xoming down until the hypo last night. It sometimes takes a week or so to 'detox' the high carb dry out of the system. This is why I had suggested a possible skip for this morning's shot after it took so long to stabilize Wilson last night...early morning for us.
     
  9. Tanya & Wilson

    Tanya & Wilson Member

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    He is now at 12.2 +2.5. Glad I missed his shot this morning. Will update again after work.
     
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  10. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    WOW Wilson is doing great for a no shot. I would have thought his numbers would be through the roof with a bounce from the hypo last nite and all the sugar and gravy and kibble he had. Good thing you decided not to shoot this morning. I will look for your post after you get home from work posting to add my 2 cents worth in for tonite's dosing. ;)
     
  11. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    I agree with the skip and drain. With a food change he was really on a mission last night's cycle.

    Tanya, I sure hope you got some sleep last night! And I sure hope you get more tonight.

    @Tuxedo Mom , what do you think about a larger reduction of at least 2.0 u? I am even comfortable with even lower than that. What do you think?
     
  12. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Bobbie I was just thinking about the evening dose and realized I would probably be asleep by that time. Getting up at 3 AM makes for a long day :rolleyes:

    I am leaning towards a maximun of 2.0 units or even 1.75 units if the numbers haven;t come up a lot from the no shot reading. Wilson's numbers have been steadily improving since the diet change and the hypo that was hard to bring up last night makes it appear that the insulin requirements have dropped with the diet change. I am sure Tanya is tired after her long night and does not want to do another late night pajama party, so I would err on the side of caution until she can do some closer monitoring, when she is at home through the cycle. If Wilson creeps up then the dose can be adjusted.

    My opinion only based on the recent diet change and how hard Tanya had to work to get Wilson's numbers up last night.
     
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  13. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    FYI - although Wilson got to 2.5 (45 in US numbers) last night, that's only a hypo if he exhibited hypo symptoms. Normal range for cats not on insulin is above 40. We don't like to see cats below 50 that are on insulin.

    If you are following SLGS, you would reduce by 0.25 units. I wouldn't go any lower than 2.0 units if you want to be extra cautious.
     
  14. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    My only concern was that the numbers were very hard to bring up last night (early morning here). It will be about another 6 hours ( I think) before Wilson's PM shot...Tanya is in Australia...so there may not be many people on at that time that could help with dosing. It is hard to make the call without seeing the preshot numbers, so I am 'thinking out loud' about erring on the side of caution. I am off to bed in a few minutes, but if others will be up later once Tanya is home and tests then a better judgement could be made then. I will check on Wilson in the early morning.
     
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  15. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    @Tanya & Wilson

    Just checking in to see how Wilson is doing. I see, as expected that his numbers were very high for the PMPS and you gave the full 2.5 unit dose. Although the numbers were high, this was partly due to the no shot and partly due to the bounce that happens after a hypo number. I tend to be very conservative in any dosing advice I suggest, but the dose should have been reduced to at a maximum to 2.25 units, although I had suggested going down to 2.0 units. According to the SLGS guidelines anytime your kitty drops below 5 mmol (90 US) a reduction of 0.25 units should be taken and held for a week unless they drop too low again. It can take a few days to recover from a bounce and dosing is based on low low a dose takes your kitty, not on the preshot numbers. Try to get another test or two in tonite, but I would suggest dropping back to the 2.25 unit at most.
     
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  16. Tanya & Wilson

    Tanya & Wilson Member

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    @Tuxedo Mom
    I was planning on only giving 2 units and changed my mind at the last minute because he was so high. He has also eaten a lot more food today compared to normal. I will test again soon.
    Slightly changed diet again as he's gone off the raw food. Back on FF cans so also getting more carbs.
     
  17. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Seeing high numbers at preshot is always scary, but the key thing to look at is just how LOW a dose will take Wilson. You can see that since removing the HC dry, the numbers have been improving so the diet change is playing into the insulin requirement. When a kitty drops too fast or too low, the body's natural defence mechanisms cause store 'glucose' to be release which brings the numbers up higher. This can affect numbers for a day or as much as 2 days. Combine that with the skipped shot in the morning and seeing that high preshot was to be expected. He will probably remain high for you tonight and possibly in the morning, but for your next shot you should reduce to at least 2.25 units. The 2.5mmol (45 US) would have called for a reduction whether you follow SLGS or TR. I will check back later and see how the numbers are doing. :bighug:
     
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  18. Tanya & Wilson

    Tanya & Wilson Member

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    Jan 25, 2018
    I will reduce his shots starting tomorrow morning. He's at 24.5 +1.5. I am waiting on delivery of syringes with 1/2 unit marks. This should make the small adjustments easier. I'll start a new thread aswell with AMPS numbers.
     
  19. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Getting the syringes with 1/2 unit markings will definitely make it easier to give the smaller increments. If you are able to get a test at +3 that should show whether Wilson plans on dropping much tonight. I am sure you need to get a good sleep to make up for last night. ;)

    I will look for your new thread and see how this cycle is going.
     
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