Garfield lantus

Discussion in 'Lantus / Levemir / Biosimilars' started by Cassandra & Garfield, Nov 10, 2019.

  1. Cassandra & Garfield

    Cassandra & Garfield Member

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    Oct 30, 2019
  2. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    Once you have some data gathered (which you do), we drop that limit from 10 to 8.3 so he's pretty close.

    Don't feed him and test again in 20-30 minutes and let's see where he's at.
     
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  3. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    I agree with Chris. Stall for a bit and let's see if Garfield's numbers continue to rise.
     
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  4. Cassandra & Garfield

    Cassandra & Garfield Member

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    Oct 30, 2019
    He went up to 289...... How weird :(
     
  5. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Not weird at all....when the last shot starts to wear off, the number can rise quickly

    Also, these are cats....they like to make things unpredictable
     
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  6. Cassandra & Garfield

    Cassandra & Garfield Member

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    Haha. Thank you very much chris. Just so I don't have to bother you all tomorrow. If he is below 8.3, aside from stalling, would I shoot and hope for the best? Thanks
     
  7. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    You are never bothering any of us!! That's what we're here for!!

    Do you have to work tomorrow? If so, how long after shooting do you have to leave?
     
  8. Cassandra & Garfield

    Cassandra & Garfield Member

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    Oct 30, 2019
    Sorry I meant Tomorrow night. Seems that so far in the morning he is never below 10. So if tomorrow night he would be at example 144 even after stalling, what should we do?​
     
  9. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    If you get a Pre-shot too low to shoot, stall, don't feed and post for help.....retest in 20-30 minutes.

    There are people here from all over the world, so usually there will be someone to help you.

    When you first shoot a lower number, we like to have someone with experience watching out for you. We have a tradition here....If someone encourages you to shoot a lower number than you've done before, they agree to stay online and watch for updates, they find someone else with experience to watch you or they tell you up front that they can't stay online.

    What we usually tell you is to get a +1 and +2 so you can intervene early IF you need to.
     
  10. Cassandra & Garfield

    Cassandra & Garfield Member

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    Oct 30, 2019
    Thank you thats great! Ill keep you guys posted to see if he is lower then 8.3 before his meals. Looking at his spreadsheet, do you think his dose will need to lowered eventually? How/when will we know? Because yesterday he went down to 43 at his +4. Thanks
     
  11. Crista & Ming

    Crista & Ming Well-Known Member

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    Jun 10, 2018
    Hi Cassandra! Yay! Nice to see you on here!

    Many of us post EVERYDAY and let people know how our kitties are doing. Take a look on the Lantus board homepage and you’ll see we have dates, names, and numbers that are updated as the day continues. These are affectionately called “condos” where we get to know each cat and caregiver. Even if you have nothing to report aside from Garfield’s numbers, we like to see you post. People will visit your condo daily to see how Garfield’s doing.

    On Facebook, I asked if you could clarify if you’re doing SLGS or TR. if you’re doing SLGS, Garfield earned a reduction today, I believe. But I know you also reduced recently. So I’ll also let some other experienced members weigh in on another reduction (another reason why we encourage dosing advice only on the board - there are more experienced people here and this board acts as a peer reviewed platform). We try not to do back to back reductions.

    I encourage you to read the stickies on the Lantus homepage and also visit other people’s condos and SS. You’ll learn a lot. And keep asking questions!
     
  12. Cassandra & Garfield

    Cassandra & Garfield Member

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    Hello! Im not sure all which approach im using. Garfield has been diabetic 8 years and has always been on 2.5u of lantus and obviously with his new wet food diet we had to reduce :)
     
  13. Crista & Ming

    Crista & Ming Well-Known Member

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    Oh wow! I missed that in your signature :) Can I ask if you have any data from those 8 years or did you recently start home testing?

    Check out this sticky: http://www.felinediabetes.com/FDMB/...y-to-shoot-handle-lower-pre-shot-numbers.147/

    That thread details the two dosing methods we follow here on FDMB. Read through it, ask questions if you need clarification, and think about which method suits you best. Of course, you can change methods whenever you think is best. By choosing a method, it helps everyone to give the right advice and recommendations.
     
  14. Cassandra & Garfield

    Cassandra & Garfield Member

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    Oct 30, 2019
    Yes but his numbers were high and really all over the place. This is from last year. I really have no idea how to decide on which method I should go with. I dont want to start at 0.5 thats for sure I think id rather lower gradually.
     

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  15. Crista & Ming

    Crista & Ming Well-Known Member

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    You don’t need to start at 0.5. The difference of methods depends on when you can change the dose and the reduction point.

    SLGS:
    • Reductions are earned when BSL go under 90.
    • You hold the dose for 7 days unless a reduction is earned
    • You do a curve at the end of the 7 days to determine if the dose needs to be changed
    TR:
    • Reductions are earned when BSL go under 50
    • You can change the dose as early as every 6 cycles
    • Kitty cannot be eating any dry food and must be on a low carb wet food
    • You need to test enough. Usually a minimum of 3-4 times a day.
     
  16. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Do you work full time or can you pretty much test any time you want to?

    On your spreadsheet, you have 8/16.1 in tonight's PMPS....is the 8 the time you tested or what? Any time you add anything other than a number, it doesn't automatically color code the US side for us so you'd have to manually add it.
     
  17. Cassandra & Garfield

    Cassandra & Garfield Member

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    Oct 30, 2019
    Oh amaziny thank you!
     
  18. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    I think Crista gave. you an incorrect link to the information on the two dosing methods. This is the correct link to the dosing methods.

    I'd also add a few points to Crista's synopsis. Even with SLGS (Start Low Go Slow), you want to do. your best to get at least 4 tests -- your two pre-shot tests and at least one test each cycle. This is prudent because Lantus dosing is based on the nadir, not the pre-shot test. You want to do what you can to catch those numbers that indicate a dose reduction is needed.

    With TR (Tight Regulation), the information that @Crista & Ming provided on reductions under 50 is accurate ONLY for a cat that is newly diagnosed (i.e., within the first year from time of diagnosis). Given that Garfield is a long term diabetic, reductions are given if:
    • numbers drop below 40
    • there are three separate cycles where numbers are below 50
    • Garfield spends a week in normal, preferably below 100, numbers.
     
  19. Cassandra & Garfield

    Cassandra & Garfield Member

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    Oct 30, 2019
    He woke up at 487 :( why?
     
  20. Crista & Ming

    Crista & Ming Well-Known Member

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    Sorry about that! Thanks @Sienne and Gabby (GA) for giving the correct info!! :smuggrin:

    here’s the correct


    Garfield is probably bouncing from the nice stretch of greens we saw yesterday AM. His body wasn’t used to it, released more sugar because of what we call a “panicky liver”, and so his numbers bounced right up to compensate for the new numbers. Bounces typically last for 6 cycles, sometimes less, depending on the cat.
     
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  21. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    This is what we fondly (not so much) refer to as a "bounce." While a normal phenomenon, it's very annoying to the kitty's caregiver. A bounce occurs if a cat drops into low numbers, numbers that are lower than the range the cat's system is used to, or numbers drop quickly. The cat's liver and pancreas react in panic mode -- they release a stored form of glucose along with counter-regulatory hormones which cause BG to spike. In essence, this is a protective mechanism. Your kitty's liver and pancreas "think" those green numbers were dangerously low (which they were not) and acted to protect Garfield.

    You saw the same thing on 9/10 - 9/11. Garfield's numbers dropped into the 40s and by the next AMPS he was in the 500s.

    The good news is that it looks like Garfield clears the bounces quickly. It can take up to 3 days for a bounce to clear.
     
  22. Cassandra & Garfield

    Cassandra & Garfield Member

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    Oct 30, 2019
    Thank you very much! So far he has bounced everytime he went below 80. If this doesnt stop happening after a while what would I do? Thanks
     
  23. Cassandra & Garfield

    Cassandra & Garfield Member

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  24. Cassandra & Garfield

    Cassandra & Garfield Member

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    Oct 30, 2019
    Thank you very much! Hopefully this will eventually stop happening as much.
     
  25. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    With some kitties, the more time they spend in normal/lower numbers, the more their system acclimates and the bouncing slows or stops. Some kitties are just bouncy and they seem to like to keep us guessing.
     
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  26. Crista & Ming

    Crista & Ming Well-Known Member

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    Ming is a good example of a bouncy kitty. He’s been at this for a year. He’s also at high dose but negative for acromegaly (which is a high dose condition).

    It’s only been recently that he’s been clearing his bounces in about 1-2 cycles.

    You can check out his SS in my signature.
     
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  27. Cassandra & Garfield

    Cassandra & Garfield Member

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    Oct 30, 2019
    Interesting! Im fascinated that you can inject Ming with 6.5 u at such low numbers! Im having trouble grasping the concept of shoot low to stay low because I cant understand how they dont go into hypo going from 4.7 with the insuline. Ive read up on shooting low numbers but im too scared to do so because I cant wrap my brain around the fact that he wouldnt wouldnt automatically go into hypo.
     
  28. Crista & Ming

    Crista & Ming Well-Known Member

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    Jun 10, 2018
    It takes practice and lots and lots of data gathering. And for me, hand holding from the wonderful people here on the board.

    Ming is also on Levemir and so his onset is supposed to be later (but sometimes he doesn’t listen...). I’m more confident shooting lower numbers on Lev than Lantus because I know he potentially has ~5 hours until onset from PS time.

    It also helps me when I get a +10 or +11 reading so i know if he’s trending UP. If his +11 is lower than PS number, then I know his BSL are going up and will continue to go up for the next couple hours.
     
  29. Cassandra & Garfield

    Cassandra & Garfield Member

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    Oct 30, 2019
    He hasnt really come down all day. He started at 486 and now is at 396. Is this normal? Usually he goes down.
     
  30. Crista & Ming

    Crista & Ming Well-Known Member

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    Jun 10, 2018
    Cassandra, as explained previously, Garfield is bouncing and there’s not much you can do aside from test for ketones just to be safe. Has Garfield been DKA before or had ketones in his urine? Apologies if that’s been already discussed.

    It can take up to 6 cycles for bounces to clear and for you to see nicer numbers.

    I encourage you again to pick a method so that advice can be tailored to that. We also make new threads everyday so I’d make a new one since this thread is getting pretty long. Here’s a post about how to post on the Lantus forum: http://www.felinediabetes.com/FDMB/...saglar-levemir-land-experience-updated.46014/
     
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  31. Cassandra & Garfield

    Cassandra & Garfield Member

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    Oct 30, 2019
    Ok perfect thank you! I think i prefer TR but im not sure how to chose. Never tested his urine with ketone strips in affraid he wont pee if im near him with the strip. Next question I will make another thread sorry about that! :)
     
  32. Sue and Luci

    Sue and Luci Well-Known Member

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    Nov 3, 2017
    I don't have 'permission' to view Garfield's SS. Can you set it up to share with everyone?
     
  33. Cassandra & Garfield

    Cassandra & Garfield Member

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    Oct 30, 2019
    Oh sorry about that! I think I changed it so everyone can see it :)
     

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