Need help dosing

Discussion in 'Lantus / Levemir / Biosimilars' started by Dex & Ollie, Jan 26, 2019.

  1. Dex & Ollie

    Dex & Ollie Member

    Joined:
    Aug 27, 2018
    Dexter has been hard to figure out recently. He's been on 2 units of Lantus for a while, but I'm wondering if he needs to be on 1.5.

    Recently, AMPS, his numbers have been fine, leading me to think he needs his full dosage. However, when I test him in the evening/PMPS, his numbers have been alarmingly low. He was at 39 PMPS recently, which was terrifying. (He came back up to 125 after he ate.)

    This leads me on a frustrating cycle: I don't feel comfortable giving him his insulin at night when he has numbers that are so low, which leads to really high numbers in the morning. When I lowered him to 1.5, his numbers have been too high.

    Does anyone have any advice?
     
  2. carfurby (GA)

    carfurby (GA) Well-Known Member

    Joined:
    Feb 19, 2012
    I can't see your SS. It says I need permission. I hope you reduced the dose after that 39. Numbers in the 30s are an automatic reduction, especially since you are using the AT meter.
     
  3. Dex & Ollie

    Dex & Ollie Member

    Joined:
    Aug 27, 2018
    Oops- updated the SS. Yes, after his 39, I didn't give a dose that night.
     
  4. carfurby (GA)

    carfurby (GA) Well-Known Member

    Joined:
    Feb 19, 2012
    It looks like he is being bouncy in the PM and clearing the bounce by the AM. Are you able to get any mid-cycle tests in? That will help up figure out how low he is going and what his dose needs to be to keep him safe.
     
  5. Dex & Ollie

    Dex & Ollie Member

    Joined:
    Aug 27, 2018
    I can get some today! I usually can't b/c of work, but I'm around all weekend. I'll test today.

    When he's being bouncy, what is the best method for dosing? Just kind of wait it out?
     
  6. carfurby (GA)

    carfurby (GA) Well-Known Member

    Joined:
    Feb 19, 2012
    If his numbers go up from bouncing, you just have to wait for them to come back down. Just keep the same dose unless you see a low number before or after the bounce where he earns a reduction.
     
  7. Dex & Ollie

    Dex & Ollie Member

    Joined:
    Aug 27, 2018
    Ok, thanks. When would you NOT dose him? Under 70? When he showed up as 39 and 53, I was afraid to give him anything.
     
  8. carfurby (GA)

    carfurby (GA) Well-Known Member

    Joined:
    Feb 19, 2012
    Have you tested anymore today yet? With the 100 at AMPS he may drop lower today. Getting extra tests in today can give you an idea of what he will do if you shoot low and help you figure out what number is a good no shoot number.
     
  9. Dex & Ollie

    Dex & Ollie Member

    Joined:
    Aug 27, 2018
    Ok, just tested. He's 284, which is +2. I gave him 1.5 units this morning, but not he's responding like he should have gotten 2 units.
     
  10. carfurby (GA)

    carfurby (GA) Well-Known Member

    Joined:
    Feb 19, 2012
    That was a pretty big bounce last night and it may be he is going to bounce today because he came down fast last night. I'd get another test at+3 to see if he is doing to keep going up.
     
  11. Dex & Ollie

    Dex & Ollie Member

    Joined:
    Aug 27, 2018
    Ok, I will. Thank you!
     
  12. carfurby (GA)

    carfurby (GA) Well-Known Member

    Joined:
    Feb 19, 2012
    Normally we make dose changes by 0.25 units. When you decreased from the 2.0 unit dose, the next dose down should have been 1.75 units. He may need to go back up to 1.75 units. Do you have syringes with half unit markings? That makes it easier to measure the in between doses.
     
  13. Dex & Ollie

    Dex & Ollie Member

    Joined:
    Aug 27, 2018
    I don't -- I bought the syringes on Amazon before realizing that they weren't for microdosing. Where do you buy yours? I seem to not be able to find them.
     
  14. carfurby (GA)

    carfurby (GA) Well-Known Member

    Joined:
    Feb 19, 2012
  15. Dex & Ollie

    Dex & Ollie Member

    Joined:
    Aug 27, 2018
    Thank you-- this is incredibly helpful!
     
  16. carfurby (GA)

    carfurby (GA) Well-Known Member

    Joined:
    Feb 19, 2012
    You're welcome. In the past I have been able to get half unit syringes at Wal-Mart, the Relions. Walgreens also sells some.
     
  17. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    A couple of notes. First, never shoot anything below 68 on the AT. Depending which dosing methodology you are following, you might want to raise that number to 90. We use two dosing methods here, Tight Regulation Protocol and the Start Low Go Slow method. Take a read of the Sticky Notes that describe them and decide which one might suit your life. The dosing methods tell you when to increase and when to decrease the dose. Anything below 68 on the AT means a dose reduction, regardless with dosing method you follow. If you are following SLGS, you would hang onto this 1.5 dose for now.

    If you can try to get a before bed test every night, they are incredibly useful data. Many cats go lower at night and we determine the dose based mostly on those lows. Second, if you see him going lower, you can leave some higher carb wet food out to keep him safe while you sleep.
     

Share This Page