10/13 Gryphon AMPS 358 & PMPS 122!

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by Cindie, Oct 13, 2018 at 9:43 PM.

  1. Cindie

    Cindie Member

    Joined:
    Sep 9, 2018
    I'm not sure what to do. PMPS 122. I checked the automatic feeder and it hadn't opened for Gryphon's last meal. He hadn't eaten for more than 9 hours. I didn't give insulin. BG is up to 185 now, 90 minutes after eating. Should I just skip the evening dose, or give a very low dose? Suggestions appreciated!!!
     
  2. Chris & China

    Chris & China Well-Known Member

    Joined:
    May 10, 2013
    Can you adjust his shot times for the next few cycles? Can you test tonight for awhile to make sure he stays safe?

    If you can, you could go ahead and shoot now and then get back to your chosen shot time by moving 15 minutes per cycle for the next several cycles.
     
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  3. Cindie

    Cindie Member

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    Sep 9, 2018
    Yes, I can adjust the shot times and continue testing for a while. I'm afraid to give him 8 units, though.
     
  4. Chris & China

    Chris & China Well-Known Member

    Joined:
    May 10, 2013
    Just a housekeeping note.....each day when you start a new thread, you should put the link to your previous thread in so it's easy for people to go back and see what's been going on.

    Here's the link to your previous thread

    One thing I do notice is that you've changed his dose several times lately. Lantus craves consistency, so we need to find a dose that you're comfortable giving both AM and PM. Each time you change the dose, you disrupt the depot so you end up with wonky numbers.

    The fact that he's going up so quickly tells me it's probably going to be safe to go ahead and give the same dose (which is why I asked if you could monitor him as long as necessary tonight)

    If it really concerns you, you could always shoot a slightly reduced dose, but we do need to start being consistent with the dose or we're never going to really know how he's doing.

    Would you feel better about giving something like 7U and holding that dose for at least 3 days?
     
  5. Cindie

    Cindie Member

    Joined:
    Sep 9, 2018
    Yes, you're right about the inconsistency recently. Gryphon has been on 8 units 2X daily for over 6 weeks and his BG has always been high, usually above 400 and as high as 600. Things have really changed the past two weeks. At times his BG has been lower than I've ever seen it, so I'm a bit nervous. I also really don't understand how Lantus works, or how any insulin works for that matter. On October 8 his AMPS was 259, much lower than usual. I gave him 7 units and he dropped to 76. This was a bit scary for me, but I was at home & free to monitor him. On October 11 his AMPS was similar, (268), and I was expecting to be away much of the day, so I reduced the dose. I probably shouldn't have reduced it that much, but I'm really just guessing at what I should be doing, based on limited experience and knowledge. The other variable is that we recently discontinued Gryphon's Prednisolone, (Oct. 2), and I'm wondering if that has started a trend of lower BG which might continue to drop as he adjusts to no Prednisolone.

    Having said all that, yes, I think I would feel better about a lower dose - I think 7U sounds good, and stay with that for a while. Thanks very much for your assistance!
     
  6. Chris & China

    Chris & China Well-Known Member

    Joined:
    May 10, 2013
    That's a very important piece of information!! It's totally possible that as the steroid works out of his system, it will effect his numbers quite a bit.

    On your spreadsheet, whatever number you actually shoot is your Pre-shot.....so if you stall for an hour (for example), you'd put the actual number you shot in the PMPS cell like this "### @ +13"

    You can put the 6.8 in the PMPS cell too....they can be "stacked" on top of each other.....put 6.8 @ +12, 10.3 @ +? (I don't know for sure when you got that)

    It's also important that he not eat for the 2 hours immediately before shot times....you said he went up to 10.3 90 minutes after eating. If you "stall", you shouldn't feed so we know for sure his numbers are going up without the influence of food.
     
  7. Cindie

    Cindie Member

    Joined:
    Sep 9, 2018
    I didn't give insulin last night. By the time I had retested and considered all of the options it was really late and I wouldn't have been able to work around a shot time that late. I hope that won't set Gryphon back too badly!! This morning I decided to give 6U because I am also eliminating kibble and I'm concerned that no kibble plus no Prednisolone might cause the BG to drop. I will hold the 6U dose for at least 3 days and try to stay calm! :) Thanks again for all your help!!
     
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