How low to go before not giving a shot?

Still very new to all this. Frost BG have been getting lower since on Lantus, but how low is too low to give an insulin shot? He currently gets 2 units twice a day. This morning his BG was 98, but tonight it was 77. The past 2 mornings his BG was in the 70's and I did not give him a shot because I wasn't going to be home with him to watch him, but with it being the PM test and heading to bed in a few hours I didn't give him his shot tonight. But I didn't know how low his BG can be and still give a shot.

 

Good that you did not shoot tonight.
It's hard to tell what's going on with only a few mid cycle tests. Please do not shoot in the morning without asking for advice.

Your signature says ReliOn Compact but your spreadsheet says AlphaTrak.

Bumping your thread up for more experienced eyes.

 

@Marje and Gracie @JeffJ Could you look at Frost's spreadsheet if you have a moment, please?

 

Hi Dorothy

Kudos to you for getting the chart going, and doing the BG testing.
Kudos for not dosing him when his pre-shot value was so low.

Lantus and Levemir effectiveness is evaluated by looking at the nadir (+6 hr) mark. So it is hard to give advice with the data provided.

For example, if Frost goes too low during mid-cycle, we need to know that. Low values are hypoglycemia, and really low values (like 15-30) can cause permanent issues and death. So we are trying to avoid that scenario (of course).

I think it is good you are doing preshot measurements. We have no idea how low your kitteh is going. I would be hesitant to continue dosing at those insulin levels until you can get more tests accomplished.

Can you start testing during the evening? Like 2 hours and 4 hours after the dose?
Can you please do mid-day tests during the weekend?
Can you confirm which meter you are using?

thx,
JeffJ

 

That's cute picture of Frost hiding in the basket!

 

Hey Dorothy! Glad you made it over here from the Facebook group!!

Are you actually using the AlphaTrak or did you just grab the wrong spreadsheet? It's not a big deal if you did...we can fix that!

Did your vet start you at 2U or did you just start testing recently? 2U is higher than we usually start unless it's a very large cat.

Getting mid-cycle testing is very important because Lantus dosing is based on how low it takes them. If at all possible, grab at least 1 mid-cycle test on the AM cycle (around 5-7 hours after the shot) and at least a "before bed" test on the PM cycle. Most cats go lower at night, so it's important for his safety. If you can't get mid-cycles on the AM cycle due to work, it's even more important to try to get a couple of tests on the PM cycle if you can.

Hang in there....there's lots of great people here that want to help you and Frost!

 

Welcome! We're newbies, too, but folks here are so helpful. You've come to the right place.

 

Also, there are shoot/don't shoot guidelines here on the Tight Regulation and Start Low Go Slow protocol page. (There's a sticky for it at the top of the Lantus forum.) I realize this might all be so new that you haven't even had a chance to check out these protocols, but they're really helpful when you can't decide what to do.

 

The sheet is with AlphaTrak. My vet had a client who turned one in to them after their cat passed and she gave it to me. I just changed my sig., thank you

 

I started with Relion, but then my vet gave me a donated AlphaTrak, so I switched Spreadsheets. I just updated the Spreadsheet to show both since he was only diagnosed 20 days ago. The vet started him on 1 unit 2x daily, then at the 2 weeks point she upped him to 2 units 2x daily. Frost is 15 pounds, but he's not a fat cat just a larger built (at least the vet said he's at a good weight for his frame and wants to me try and maintain him at this weight). He's been around this weight all his adult life (give or take a few ounces here or there, but never more than that).

Frost still isn't very compliant when I test him, and to try and test him multiple times right now just stress us both out and I know my stress makes his worse. (Plus working - single so no one here to help out when I'm not home) I've tried wrapping him in a towel, freeze-dried treats while I'm talking and petting him before and after. But I think he has more muscles in his ears than a normal cat! *sign* Luckily, he doesn't fight me when I give him his insulin shots.

Couldn't test him this morning because he's currently hiding under my bed since the roofers showed up at 7AM. I have a feeling I may not see him for a few hours. I couldn't even coax him out with his favorite freeze-dried minnow treats.

Luckily, he's eating regularly and his drinking seems to have normalized (and I can only tell that because he seems to only pee about 2 or 3 times a day now - still won't pee in the litter box though.

 

Thanks!

 

Welcome Dorothy! Frost is adorable in his basket!

 

That was his favorite spot. It was especially cute when he was little and shared it with his adopted brother - whom we lost in Dec '18 to heart failure Poor Frost has had 2 wammies in 6 months Haven't seem him in it since he's been diagnosed.

 

What a dose of Friday Cuteness. Those two boys look so sweet. I'm sorry to hear that Frost lost his brother. It can be really hard on bonded kittehs.

We had the same thing here a couple weeks ago when Leo passed. Little Dude has weathered the storm and become better buddies with the little doglets and Theresa. I hope Frost is coping well with his loss.

For dosing and testing issues.
Years ago, we taught Leo that if he got on the "special, reserved" little whale soft blanket, that he would get a special treat. We would keep the blanket stored away. When we got out the blanket, he would get a treat if he came over and laid on it. That took some training. But I'm not kidding you, every time for years after, he would just come over and lay on the "testing blanket" for us. So that may help. Leoberry was such a special little boy, and we miss him dearly.

 

I agree with Jeff - get a special towel or blanket to reserve as your special testing place. The first few (ok, maybe not few) times put it where ever it's most comfortable for both of you - offer a treat and lots of loving for just being there - let him go on to do whatever he wants to do...try to do that as often as you can during the time when you're home - soon he'll associate that blanket/towel, etc. with that treat and the good times he has there. Luci waits on the part of our kitchen counter that we use as our breakfast area (and yes, I have Clorox wipes to use every time Miss LB gets up there and walks around!) - but it's the easiest place for me to see what I'm doing and hold her in place.

So that might help with that - it does take time and patience - sorry he can't be tempted out just now with the treat - but I wouldn't come out either with those scary roofers making all that noise!

I also agree no need to give insulin without seeing how low the current dose is taking him. Typically cats go lower after getting their insulin - so without those mid-cycle tests you're playing with fire. Hope you can get some on the weekends and at night - before going to bed if you can get a 2+.

Welcome to our group! I know there's a lot of information to absorb and a lot of people will give you various bits of advice and support - everyone means well - but it can be overwhelming initially.

At any rate - welcome - looking forward to seeing your condo tomorrow

Please post like this tomorrow: 7/20/ Frost AMPS - question if you have one - or comment - and people will view your condo and make comments throughout the day - it's not quite as active as it is on the weekdays - but people are around day and and night to help and guide you.

 

Jeff is spot on -- Lantus dosing is based on the lowest number in the cycle (the nadir), not your pre-shot values. What that means if you need to get some spot checks during both the AM and PM cycles. It will also be helpful to get a curve so you know when Lantus onset and nadir fall.