11/26 Sherlock AMPS 329, +3 229, PMBG 80, +13 123, +16 216

Discussion in 'Lantus / Levemir / Biosimilars' started by LexaJoy, Nov 26, 2018.

  1. LexaJoy

    LexaJoy Member

    Joined:
    Sep 13, 2018
    Sherlock has thrown me for a loop this afternoon with that low number. I've never seen one that low and don't want to give his afternoon dose of insulin because... yikes. Is skipping the afternoon dose the best idea at that number? The lowest I've shot before is 172, and that's what tipped us into trouble a couple of weeks ago.

    Advice?

    ETA: Okay, got no response here so I guess we're making the executive decision to skip this afternoon's dose. His number has gone up in the last hour, but it's still lower than I'm comfortable shooting. Guess we're just having an off day.
     
    Last edited: Nov 26, 2018
  2. Christie & Maverick

    Christie & Maverick Well-Known Member

    Joined:
    Aug 1, 2017
    Sorry no one was around earlier to offer some advice. Good choice skipping. With SLGS, you don't shoot under 90. And, you should take a 0.25u reduction because of that 80 on the next shot tomorrow am. Normally, if you get a low preshot like that, if you can stall, don't feed, and see if kitty comes up to a comfortable, shootable number, and if you can adjust shot times then that is an option. Looks like by +1 you still weren't quite comfortable shooting (not sure if you fed and that +1 has a bit of food influence?), but Sherlock will get back on track tomorrow. Has Sherlock ever had issues with ketones? With kitties who are prone to ketones, it is often suggested to monitor (there are human ketone pee sticks) because of the skip in insulin, but if Sherlock hasn't previous issues with ketones, it likely won't be a huge concern. Hope this helps, I have to get insulin ready for my Maverick but wanted to quickly offer some thoughts for you. :)

    Oh...and that PMPS should say PMBG so people know you didn't shoot ;), and next reading is actually then +13
     
  3. LexaJoy

    LexaJoy Member

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    Sep 13, 2018
    Thank you!

    Sherlock has never had a problem with ketones, but I got the little sticks after his diagnosis since at the time we weren't doing insulin. I didn't want to get into a bad spot with him. As of 3 hours post his usual shot time, we're finally in a spot I would shoot.... but. Too late for tonight, so we'll start again tomorrow.

    I'm a little flustered because we backed off of 1.75 two weeks ago because of hitting low numbers, and then over a week of 1.5 didn't get us into a good spot. I'm not sure if there's some dose between those that might be right? But we'll go back down to 1.5 tomorrow just to be safe.
     
  4. Christie & Maverick

    Christie & Maverick Well-Known Member

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    Aug 1, 2017
    You're welcome! I didn't see a post today but I had some more thoughts. I think you mentioned you aren't always able to test mid cycle, but with yesterday's drop at am +3, when my kitty drops like that, I've had some success with feeding him a bit higher carb, to slow the drop. Tough part is you can't see if it is necessary because you can't compare to what would happen if you hadn't fed some extra carbs. I'd be looking for something of a drop around 20% by +2 or +3...that might mean a more active cycle. The idea is that if you feed when you see the sharper drops, you can hopefully keep the numbers from dropping too quickly, and maybe then holding the dose longer. Something to keep in mind anyway. Hope Sherlock didn't bounce too high today :) Mav is a bouncy fella too, so he and Sherlock are likely hanging out together on the trampoline today :rolleyes:
     
  5. LexaJoy

    LexaJoy Member

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    Sep 13, 2018
    He did bounce a bit this morning, since his +3 this AM hit a 405. Womp. He was back down in the yellows this afternoon, so. Not too bad? But we could be better.

    Because the wifey and I both work full time, I feed at 3 AM (his first shot) and she feeds at +3, and then we're both gone all day. I get home just in time for his PM shot at 3 PM, and then he eats again at night on +3 and +6. I've debated trying to figure out how to get another meal into the day, but with both of us gone, it's tricky. We can't leave food down (the dog loves it), and if we got a timed feeder, there's a risk his brother might get the food instead. I dunno. There's no perfect solution.

    I did tell my wife that if she sees a crazy drop on +3, like we saw yesterday, to maybe hang a little longer and see about where he's going. We do keep some high carb foods, so maybe she could mix a little in if we're worried?
     
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  6. Christie & Maverick

    Christie & Maverick Well-Known Member

    Joined:
    Aug 1, 2017
    That is a dilemma, I know my pup loves the kitty food too! Yes, I think if your wife can feed some higher carb on a crazy drop like yesterday, that might work to slow things down so next preshot isn't too low. That, and sometimes kitties bounce because of the sharper drops too, so it helps if you happen to have a bouncy kitty. Just sharing from what I have tried to do along the way, it does take some experimenting.
     
  7. LexaJoy

    LexaJoy Member

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    Sep 13, 2018
    I hadn't considered a little higher carb if we're seeing a sharp drop on that +3, so. That is helpful! I'll talk to my wife about it. We haven't been doing this kind of insulin long, and it's pretty wildly different from the vetsulin my other kitty used. Learning curve, lol. We're working on it.

    Thank you so much for weighing in. I really do appreciate it.
     
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  8. Christie & Maverick

    Christie & Maverick Well-Known Member

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    Aug 1, 2017
    Happy to offer my thoughts, any time. I don't know much about vetsulin than what I have read here. With Lantus, you get some of the depot effect, and my recollection is that vestsulin is not as long acting, but kicks in quickly? I find with Lantus my kitty onsets around +3, which is why the +3 helps me decide if I need to give higher carb food, some people like the +2 also, it can be an early indication of an active cycle, especially if you see more than 20% lower than preshot.

    Believe me, I understand that learning curve, I think you guys are doing very well! You'll get used to Sherlock's patterns soon, and of course, he'll then switch things up just for fun :D
     
  9. LexaJoy

    LexaJoy Member

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    Sep 13, 2018
    We were only with vetsulin for about four months with Ianto before a hypo event took him from us. That was before I knew about testing or any of the stuff here, so this has already been tremendously helpful. Vetsulin pretty much smashed his BG into the floor (from what I understand), but it didn't last so his numbers were always wonked. Sherlock is already doing better than Ianto ever did, and I'm super grateful for this site and folks like you. I don't think I could've committed to doing insulin again without the support.
     
  10. Christie & Maverick

    Christie & Maverick Well-Known Member

    Joined:
    Aug 1, 2017

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