8/24. Elmo...need help

Discussion in 'Lantus / Levemir / Biosimilars' started by Beth 73, Aug 24, 2019.

  1. Beth 73

    Beth 73 Well-Known Member

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    Aug 2, 2016
    @carfurby To see you were on was an answered prayer ! Elmo has been on insulin for last 10 days due to infection . Vet started at .5 with AMBG /PMBGs of 300. After 3 days she advised upping to 1 ....AMBGs were 200 but would climbed to 500 last night. Vet advised upping to 1.5 today( with AMBG of 500)....tonight's PMBG was 112. What should I expect tomorrow morning ? I've read ab bounces and need dose advice for tomorrow morning. Elmo has been in remission since January 2017 and this has left me feeling like a newbie ! Like rerun of a bad movie . Thank you in advance for all help. Also, I skipped tonight's shot ...I was shell shocked .
     
  2. carfurby (GA)

    carfurby (GA) Well-Known Member

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    Beth I'm sorry to hear Elmo has an infection. Did you increase the dose to 1.5 units? What did you shoot tonight? Is there any way you can update Elmo's SS?
     
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  3. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Oh Beth, I am so so sorry to hear my nephew had to go back on the juice. He'll be back off it soon enough. Tell him Auntie Linda says he's to behave and get well soon.

    I was just about to mention updating the spreadsheet too. If Elmo is on insulin right now then those numbers are AMPS/PMPS.
    You really must feel like a newbie since Elmo didn't give you any chance to work with Lantus before going OTJ. :bighug::bighug::bighug::bighug:
     
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  4. Beth 73

    Beth 73 Well-Known Member

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    Carla !!! So glad to see you. Yes, I did increase to 1.5 this morning . I did not shoot tonight . It scared the bejiggers out of me . We never started Lantus but went right into OTJ trial in January 2017 so to say I'm rusty at this would be an understatement . I will try to get what numbers I have from last 10 days entered on ss. If not may just enter them in this thread . :bighug::bighug:
     
  5. Beth 73

    Beth 73 Well-Known Member

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    Linda !!! Ok , now I'm gonna cry !!! I'll try to get numbers entered but our main computer is a bit wonky . This all hit out of the blue after 2years remission so I wasn't thinking FDMB clearly ! :bighug::bighug::bighug:
     
  6. carfurby (GA)

    carfurby (GA) Well-Known Member

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    I'm glad you didn't shoot tonight. To refresh your memory we usually make dose changes in 0.25 increments, not 0.5 like the vet is suggesting. Elmo will most likely bounce in the morning from the skipped shot. You should still get some test in tonight to make sure he's okay since he has a depot from this morning's shot. I'd test at +1 and +2.
     
  7. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    May 18, 2016
    Hi Beth,
    Nice to see you but sorry Elmo is back here – hopefully not for long. :bighug:
     
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  8. carfurby (GA)

    carfurby (GA) Well-Known Member

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    You may want to reduce the dose back to 1 unit in the morning, or at least 1.25 units. Have you been able to get any mid cycle tests in to see how low the dose is taking Elmo? A lot of vets give dose advice based on the pre-shot numbers and not the nadir.
     
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  9. Beth 73

    Beth 73 Well-Known Member

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    Going to skip from January straight to last 10 days ...really hate to see black and red on his ss...I dreaded that :(
     
  10. Beth 73

    Beth 73 Well-Known Member

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    Carla, she actually suggested 2 and my FDMB self said " noooo". Even tho I've only ever used Vetsulin and even then Linda and Kris held my hand ( and Elmo's paw) thru the whole thing :bighug::bighug::bighug::bighug:
     
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  11. Beth 73

    Beth 73 Well-Known Member

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    Don't have much data ...was in denial ...posting what I have ...
     
  12. Jill & Scooter

    Jill & Scooter Well-Known Member

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    Mar 7, 2018
    So sorry Elmo has an infection and is back on the juice! I'm sure it will take a bit to get back in the swing of things, but as you know, you'll get plenty of help here.
     
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  13. Beth 73

    Beth 73 Well-Known Member

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    What numbers I have are entered . Ashamed at woeful lack . :( We had been fighting back numbers creeping up since June with antibiotics . Most likely dental but he is not a candidate for any procedure . Each time the antibiotics worked to bring them down to 120s range . Will have to dig up notebook tomorrow with rest of 2019 numbers .
     
  14. Beth 73

    Beth 73 Well-Known Member

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    :bighug:
     
  15. carfurby (GA)

    carfurby (GA) Well-Known Member

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    If you can you should get some night time tests in. It looks like Elmo may be dipping lower at night and bouncing during the day. I would go to 1.25 units tomorrow morning and try and get some mid cycle tests in to see where Elmo's nadir is. I'm so sorry he's back on insulin. Hopefully once the infection clears up he'll get right back off.
     
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  16. Beth 73

    Beth 73 Well-Known Member

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    Jill, the deal is we never started Lantus . Elmo became known as the Cat Who Smelled Lantus because it was in the frig but never used
     
  17. carfurby (GA)

    carfurby (GA) Well-Known Member

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    Don't forget to put NS on the SS for tonight since you skipped his shot.
     
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  18. Beth 73

    Beth 73 Well-Known Member

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    Aug 2, 2016
    I know you know, Carla, about coming out of remission with sweet Furball. It's a shock to the system for sure , then to start using an insulin we have no experience with makes it super interesting .
     
  19. carfurby (GA)

    carfurby (GA) Well-Known Member

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    I forgot Elmo was never on Lantus. I'll be logging off soon to get some sleep. Post an update in the morning so we know what's going on with Elmo after the skipped shot.
     
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  20. Beth 73

    Beth 73 Well-Known Member

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    Carla, you are a lifesaver :bighug: I've missed checking on everyone but my 96 year old momma passed away in January and being the oldest and trustee it has been crazy . It has consumed us .
     
  21. Beth 73

    Beth 73 Well-Known Member

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    :bighug:❤️:bighug:
     
  22. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    LOL! I remember that! We could have written a very entertaining book about those days!
     
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  23. carfurby (GA)

    carfurby (GA) Well-Known Member

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    I'm so sorry about your mom. :bighug::bighug::bighug:
     
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  24. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I'm so sorry to hear about your Mom Beth. This is not what you needed right now but you and Elmo will be fine. You'll get your Lantus legs very soon!
     
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  25. Beth 73

    Beth 73 Well-Known Member

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    Linda , I was thrilled to hear ab Menace ! How is she and ur other fur babies ?
     
  26. Jill & Scooter

    Jill & Scooter Well-Known Member

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    Reread and see that now. Scooter was on vetsulin at first. Lantus is very different. You will definitely have a learning curve! I like Lantus much better. I hope Elmo gets over his infection quickly and gets right back off the juice!

    So sorry about your mom. :bighug::bighug::bighug:
     
  27. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Menace is doing great! Coming up on her 1 yr. anniversary in September. antijinx-emoticon.png My middle child is fine too. Unfortunately, time is running short for my 21+ old guy and I'll be saying my farewells to him in the very near future. This past week he's had more bad than good days and his appetite has been off the last 2 days so I think I'm going to have to make the call in the next week or 2. :(
     
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  28. Beth 73

    Beth 73 Well-Known Member

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    Awww, been thinking ab Myster lately .:bighug: At first we thot Elmo was getting ready to pass but he keeps hanging in there . It's wonderful but hard when they get to be he and Elmo's age. Will be keeping you and Myster in my thoughts and prayers Couple of questions : Should I be syringing Elmo food tonight before bed ? And should I be monitoring his BG tonight ?
     
  29. Beth 73

    Beth 73 Well-Known Member

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    Also should I be giving him his SQ fluids as usual ?
     
  30. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Absolutely keep doing the SubQ fluids as you normally would. Keeping Elmo hydrated is important and helps with BG.
    Is Elmo not eating on his own? Feed him as you usually do despite no shot tonight.

    I would get a test at +1 and +2 to make sure he's staying steady or rising. He's still got the depot from previous shots at work. Not that he's likely to do any dramatic diving but it's good to know what he's up to given that low at PMPS even with a skipped shot.
     
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  31. Beth 73

    Beth 73 Well-Known Member

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    Linda , thank you beyond thank you :bighug: Feels like the good ole days ❤️ Not a day went by when I came to the Board that you, Kris and Mogs weren't on my mind and heart . What a special group of Fairy God Mothers for Elmo ❤️ You all are the BEST :bighug: Nighty night and please give Myster extra scritches from me .
     
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  32. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Scritches delivered. mini-graphics-cats-075086.gif for Elmo. :bighug::bighug::bighug::bighug: for you.
     
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  33. Beth 73

    Beth 73 Well-Known Member

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    +3....192 .....
     
  34. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Sorry to hear you are having to visit us for real this time.:bighug: Lantus is a depot insulin - it takes 5-7 days to build up the initial depot. The initial increases were done too soon. As well as increased by too much. I would go back to 1 unit, and get a before bed test in once you start shooting again. I expect this morning was a bounce from whatever he did last night. Those mid cycle tests will tell us what is really happening.
     
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  35. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Jun 15, 2015
    Oh Beth sorry to see you here “for real “ this time! I remember when Elmo went into remission from just you getting the Lantus in the refrigerator!

    It is quite an upset when they lose remission. Just work the protocol and keep asking questions. We are here to help you.

    I suppose he’s not a candidate for a dental because of his age? Or are there other health concerns to keep him out of anesthesia ?
     
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  36. Beth 73

    Beth 73 Well-Known Member

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    Thanks , Bobbie :bighug: I know you know , in spades. No, he is not a candidate for anesthesia because of fragile kidneys and long term hyperthyroid treatment . So glad to have al of you here to walk me thru this. Feel like a newbie. Hope ur momma is well :bighug:
     
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