1/18 Slashy AMPS 154 +3 254 +6 294 +9 268 PMPS 241 +3 217

Discussion in 'Lantus / Levemir / Biosimilars' started by Slashy & Rick, Jan 18, 2010.

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  1. Slashy & Rick

    Slashy & Rick Member

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  2. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Re: 1/18 Slashy AMPS 154 +3 254 pain question

    Hope you feel better!

    A bounce is possible. The problem is you don't have any PM spot checks to know whether Slashy's numbers were low in the evening. Given his PMPS and the tendency for many cats to have lower numbers in the evening, he may have seen green. I know I'm among those here who keep saying this but please do what you can to get those PM spot checks in.

    Pain can also drive up BG. I can't remember when you saw your vet and got all of the meds but I don't think it was that long ago. I'd see about getting more bupe. I've had limited experience with pancreatitis but I'm pretty sure Gabby had at least a week's worth of pain meds. One of the other beans here may be able to give you a better idea of how long you may need to treat for pain. Is Slashy looking like he's uncomfortable?
     
  3. Cassandra and Sasha

    Cassandra and Sasha Well-Known Member

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    Re: 1/18 Slashy AMPS 154 +3 254 +6 294 - pain question

    I think it could be lack of pain meds or a bounce, but you are also now seeing the last of the 5u shed emptying out, and that will bring higher numbers most likely as that was the correct dose that he worked up to. With a shed that large it does take days to drain completely. He could have gone very low last night too, and we wouldn't know because of the lack of checks.

    How many days total did you give pain meds for? Is he back to 100% now?
     
  4. Slashy & Rick

    Slashy & Rick Member

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    Re: 1/18 Slashy AMPS 154 +3 254 +6 294 - pain question


    Hello..what do yo umean by " last of the 5u shed emptying out"? Not sure I understand.

    He spent the night of the 12th at the vets, came home with me after work on the 13th.. He was on the pain med's 2x/day until this am. Ran out last night.
     
  5. Cassandra and Sasha

    Cassandra and Sasha Well-Known Member

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    Re: 1/18 Slashy AMPS 154 +3 254 +6 294 - pain question

    There is an Insulin Depot/Storage Shed with Lantus and Levemir, that once filled continue to lower the BGs long after a shot has been given. The bigger the shed, the more residual insulin has been built up and continues to work after a lowered dose, a skipped shot, and stopping insulin completely. That is why with the L insulins often you can skip a dose on a large shed and not really see a huge impact, whereas if you were using another insulin you may see much higher numbers after a skipped dose. The shed is continuing to drive the BGs down, even though no new insulin is given.

    When you lowered the dose to 4u from 5u, the 5u dose was still working in Slashy long after you stopped giving that dose. Then the shed began to drain, and now you are seeing mostly the 4u dose at work alone. The 4u dose was not the dose he had worked up to, so it is very likely that it is not enough insulin to cover the needs of Slashy's shed. It is rare to be able to drop by a full unit and not see any impact - that is why we reduce doses in smaller amounts of 0.25u or less.

    You see how the numbers gradually began to increase after you dropped the dose? That is the shed draining. First you had some green, and then mostly blue, and now to yellow as there is less insulin working in Slashy.

    If you want to test and see if it is the lack of pain meds causing the elevation, you can try more doses of pain meds without increasing the insulin dose and see if the BGs come back down.
     
  6. Slashy & Rick

    Slashy & Rick Member

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    Re: 1/18 Slashy AMPS 154 +3 254 +6 294 - pain question

    Cassandra..this is very helpful. I do have pain meds on the way. There is a good chance I will be home again tomorrow for close monitoring.
     
  7. Slashy & Rick

    Slashy & Rick Member

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