? 11-10-2019 Apple, dose advice needed

Discussion in 'Lantus / Levemir / Biosimilars' started by Caren & Apple, Nov 10, 2019.

  1. Caren & Apple

    Caren & Apple Member

    Joined:
    Oct 15, 2019
    Looking for information on appropriate dosage. Vet said 2 units in morning, but of course this was incorrect. Trying to figure out if the l unit every 12 hours is indeed correct
    upload_2019-11-10_15-35-14.png
     
  2. Sue and Luci

    Sue and Luci Well-Known Member

    Joined:
    Nov 3, 2017
    Hi Caren, looks like this is your first post to the LB&L forum! WELCOME!

    Looks like Apple is a bit high right now, but it would be more helpful to see what's been going on in the middle part of the day. On 11/7 you did a curve - nice job there with the testing! Do you work outside of the home the other days? One thing that's very helpful if you can't get many daytime tests is to adjust your shot time - IF POSSIBLE to allow you to get a test before you leave for work...and also to be sure to get a test or two in the evening before going to bed.

    There is some housekeeping that you'll want to do as well...we all attach our spreadsheets via the link in the signature - rather than posting a picture of it within the condo - we'll get all that straightened out.

    So before you go to change the dose, would you be able to put the spreadsheet into the attached one that is linked?

    Also add some info about your kitty to your signature - look at some of our signatures - we all have when the diagnosis was made; which type of insulin we're using; what type of food we're feeding - a little description of Apple (boy, girl?) There is a limit of how long the signature can be but it's so helpful to others when they're reading your condo.

    Let's see if we can get some more eyes on you and Apple today to help guide you to help Apple.

    Again, welcome to the best place on the internet to help you both! :bighug:

    Edited: And to answer your question we usually dose every 12 hours - so you're doing great with that. I've even added a column to my SS to indicate the time - so I can be sure to only administer insulin every 12 hours. We've traveled recently, so we got a little off schedule...but we're back on our routine now. :)
     
  3. Sue and Luci

    Sue and Luci Well-Known Member

    Joined:
    Nov 3, 2017
  4. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    Welcome, Caren.

    I hate to say this but there's really not enough information on your spreadsheet for me to feel comfortable providing a dose suggestion. Lantus dosing is based on the lowest number in the cycle (i.e., the nadir) and not on pre-shot numbers. There's minimal spot checks to help inform a decision. If you're not at home during the day, it's very important that you get tests during the PM cycle.

    I'm sure you're looking at the pre-shot values and thinking that numbers won't be dropping low. While that may be the case, my kitty was very capable of starting her day with numbers in the 400s, dropping to the 40s by nadir, and bouncing back to the 400s by the evening shot time. If the only data I had were the pre-shot numbers, I would have increased Gabby's dose when a dose reduction was needed. The pre-shot values do not give you the full picture and no one here wants to make a suggestion that would cause symptomatic hypoglycemia.

    Can you try to get at least 4 tests per day -- your two pre-shot tests and one test during both the AM and PM cycle -- so we can work on figuring out a dose?
     
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  5. Caren & Apple

    Caren & Apple Member

    Joined:
    Oct 15, 2019
    Absolutely, I can start this evening. Do the other tests need to be done after withholding food for 2 hours or is that part of the process? He's ravenous still
     
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  6. Sandra And Buddy (GA)

    Sandra And Buddy (GA) Well-Known Member

    Joined:
    Oct 4, 2019
    Welcome to FDMB!

    You will love it here, everyone is friendly and super helpful! Just follow the advice you are given and soon you will be comfortable with everything. It can be scary at first but will get much easier. I am pretty new myself, but if I can help you with anything I will :)
     
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  7. Sue and Luci

    Sue and Luci Well-Known Member

    Joined:
    Nov 3, 2017
    No, that's only for the pre-shot test. So only twice a day should you withhold food - it just helps you get a better picture of what Apple's BG is without food. Otherwise I'm a proponent of feeding kitty when kitty is hungry - which in my case is just about 'free feeding'. Luci only has her food taken up two hours before PM and AM tests. She's a grazer...eats a little, then goes back and eats a little more...and on and on it goes throughout the day...when her bowl runs out, she comes and stares at me ... waiting...as if I should know that her bowl has gone empty...and I'm to get in there and remedy that ASAP! :facepalm:
     
  8. Caren & Apple

    Caren & Apple Member

    Joined:
    Oct 15, 2019
    Thank you for welcoming me! I really need to chill and get good advice :)
     
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  9. Caren & Apple

    Caren & Apple Member

    Joined:
    Oct 15, 2019
    I have too much competition for the wet food and Apple would gladly eat the dry I now feed in the bathroom with the door locked. But good to know I can just test randomly without with holding food
     
  10. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    The only time you need to be attentive to testing and feeding is in the 2 hour window prior to shot time. You don't want the pre-shot number to be influenced by food. Otherwise, feed Apple the way you ordinarily do and get some tests in.

    Not to scare you, but look at Gabby's spreadsheet. I was a testaholic -- I like data!! I was going to suggest looking at Sue or Sandra's spreadsheets but they test like crazy too. Perhaps as a way of getting acquainted, you can visit other threads and look at some of the other kitties's spreadsheets. It will give you a feel for the variability in the way people here test.
     
  11. Sue and Luci

    Sue and Luci Well-Known Member

    Joined:
    Nov 3, 2017
    Here's a suggestion about how to add to your signature: Click on your name at the top of this page:
    Then you'll see on the left, a list - one of them say 'Signature'.

    Here's what mine looks like:
    upload_2019-11-10_16-15-6.png

    You may want to add some info about the kind of meter you're using; and info about Apple. Type of insulin, food, etc.
    The link to the Spreadsheet is the first thing in our signature - so you'll just want to add to your signature the other relevant info.

    Thanks! :D
     
  12. Caren & Apple

    Caren & Apple Member

    Joined:
    Oct 15, 2019
    Thank you for your help, I will be posting additional numbers as I test, and will come back and see if we can see if the dosage needs adjusting. Thank you all so much!
     
  13. Sue and Luci

    Sue and Luci Well-Known Member

    Joined:
    Nov 3, 2017
    Hope you can get a photo of Apple loaded soon too....always love seeing the kitties cute little faces here :)
     
  14. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Hello and welcome to you and sweet Apple. I am glad you will be able to get a few mid cycle tests in the next little while. My girl, like Sienne’s, could drop from red to below 50 and back up high in a single cycle, especially when she was new to diabetes.

    I tested a bit less than these folks here, unless necessary. It also got better over time, as I learned Neko’s onset, nadir and duration and could be a bit more strategic at testing. Gabby and also Luci have reputations as divas, hence the need for more testing. :p
     
  15. Caren & Apple

    Caren & Apple Member

    Joined:
    Oct 15, 2019
    Done! =)
     
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  16. Caren & Apple

    Caren & Apple Member

    Joined:
    Oct 15, 2019
    Thank you for the information! I'll get more numbers on the spreadsheet starting this evening =)
     
  17. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    Hi Caren

    That SS is one from a FB group who pirated our SS. We ask all members coming from another group to use our SS. The instructions are here.

    The reason we want members to use our SS is because we’ve found the ones from other groups don’t function properly here. Quite often, they shut down as soon as they are opened. Therefore, in order for us to be able to give you the best help, you need to be using our SS.

    If you would like me to do one of our SSs for you and transfer your data to it, I’d be happy to. Just send me a PM by clicking on Marje and Gracie to the left and then “start a conversation”.

    Welcome to the forum!
     
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  18. Sue and Luci

    Sue and Luci Well-Known Member

    Joined:
    Nov 3, 2017
    Awwwww... he’s precious. ❤️❤️❤️
     
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  19. Sonia & Leo

    Sonia & Leo Well-Known Member

    Joined:
    May 24, 2018
    Hi Caren and Apple! Welcome to the forum!

    You're definitely in the right place for great advice on how to help Apple, there are so many knowledgeable people and wonderful moral support.

    Apple, you're such a cutie with your big green eyes! :bighug:
     
    Caren & Apple likes this.
  20. Olive & Paula

    Olive & Paula Well-Known Member

    Joined:
    Sep 6, 2015
    Welcome Caren and Apple. Love the name. Sienne mentioned looking at other ss. being home I'm usually a testaholic, but under renovation now (since 10/28) so I can't get to many tests in. I work all day on Saturdays so only AM test until PM test. Olive can hit nadir @ +4 or +6 - 8. I have learned to get a bedtime test every single night which is +6 for me. Can be surprised sometimes what pops up. She can be climbing my leg for food the first 4 hrs of shot, or has days of not eating until +5. I use a microchip feeder so she can access it whenever and refill when empty. Then I have a husband who feeds whenever. Just look at the different times I test. Ollie is not one to copy when to change doses. She is an acro cat and it makes a difference. You can only test when you can, data is always appreciated here.
     
  21. Caren & Apple

    Caren & Apple Member

    Joined:
    Oct 15, 2019
    Adding new times to SS. 9:00 p.m. BG 191 then 11:00 p.m. BG 186 tonight. Is this normal to go down from 391 at 6:30 p.m. pre shot read?
     
  22. Caren & Apple

    Caren & Apple Member

    Joined:
    Oct 15, 2019
     
  23. Caren & Apple

    Caren & Apple Member

    Joined:
    Oct 15, 2019
    Thank you Paula and Olive-I am surprised with what I'm seeing after shot at 6:30 then testing at 9 and 11. I hope it's considered normal?
     
  24. Caren & Apple

    Caren & Apple Member

    Joined:
    Oct 15, 2019
    Thank you Sonia and Leo!
     
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  25. Caren & Apple

    Caren & Apple Member

    Joined:
    Oct 15, 2019
    Marje and Gracie-That would be fantastic if you could do that for us. We're trying to get the hang of this and need all the help we can get :) Thank you for the offer
     
  26. Caren & Apple

    Caren & Apple Member

    Joined:
    Oct 15, 2019
    Thank you Sienne and Gabby-I'll take a look in the morning.
     
  27. Caren & Apple

    Caren & Apple Member

    Joined:
    Oct 15, 2019
    We'll transfer info to your spreadsheet when my g/d gets home tomorrow.
     
  28. Caren & Apple

    Caren & Apple Member

    Joined:
    Oct 15, 2019
    Yes we will. We needed to know a couple of things that have been answered to feel confident in getting correct test numbers.
     
  29. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    Glad to see you make it over here from the Facebook group Caren!!

    That's a pretty significant drop at +3, but the +5 looks like he has leveled out so he should be fine for tonight!

    If you happen to get up later in the night, it's always a good idea to grab a quick test......a lot of us will drink a big glass of water in the evening so we "have to" get up ;)

    Believe it or not, it won't be long before you'll be able to test without totally waking up!
     
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  30. Sue and Luci

    Sue and Luci Well-Known Member

    Joined:
    Nov 3, 2017
    That just means the insulin is working - it's great news! I'll be glad when your SS is working properly...not sure what I was looking at this morning..:p So happy to have you here Caren!
     
  31. Caren & Apple

    Caren & Apple Member

    Joined:
    Oct 15, 2019
    Thank you for everything, Sue!
     
  32. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    Good morning!!

    A quick housekeeping note -- remember to start a new thread for today (11/11). You'll want to link this thread to your new thread. (We also refer to a thread as a "condo.") We always link the previous day's posts to the current thread so it's easy to back track if you need to.)
     
  33. Bellasmom

    Bellasmom Well-Known Member

    Joined:
    Feb 12, 2018
    Welcome!! Looks like u have really good advice from other members and u are in the best place here u could be
     

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