12/05 AMPS: 71. 30 MINS: 92 DROP BY HOW MUCH?

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by DevilPup, Dec 5, 2018.

  1. DevilPup

    DevilPup Member

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    Jul 10, 2018
    I guess this this is the drop I have waited for. He has been increased over the last three weeks from .75U up to 2U. I need to drop him today. I did not shoot him yet. I am waiting another 15 min. Test again. I would like to drop a whole unit. But I'm sure you will say that is too much. I know and understand this is a depot insulin. Yesterday I was saying how his body will tell me when to drop. It is this morning.

    ****UPDATE: WAITED 30 MINS. TESTED AGAIN. UP TO 92. I WOULD LIKE TO DROP .5 TO 1.5U. HE IS HUNGRY. HE NEEDS TO EAT.

    He is also going to Vet today for ultrasound. I don't want to loose him at the vets. Suggestions for dropping? I can deal with having to get him back down, but seriously, this is pretty low.....
     
    Last edited: Dec 5, 2018
  2. Cindy&Taco

    Cindy&Taco Member

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    Oct 21, 2017
    I can't give you dosing advice :( But, since he's so low, maybe you should skip? You can start anew with your 1 unit tonight when you come back from the vet. Just a suggestion.
     
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  3. Cindy&Taco

    Cindy&Taco Member

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    Oct 21, 2017
    SLGS says do not shoot under 90, if you feel comfortable with the 92, then feed him and give him a token dose, do you have something around 6-9 carbs?AND KEEP TESTING!! :)
     
  4. DevilPup

    DevilPup Member

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    I fed him regular LC. He didn't seem like he wanted to eat. But he ate it all. He just isn't feeling good, that's why the U/S today. I gave him about a tsp of Med Carb food. But I would like to give him a token. Perhaps .5U. He is just not himself this morning. He seems very tired. He seems very unwell. Thank you for replying.
     
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  5. Cindy&Taco

    Cindy&Taco Member

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    Oct 21, 2017
    you're welcome :) In the near future one of the best tests you can do is at +11, that way you can get an idea of what his amps & Pmps will be like and you will be prepared. He may have gone lower before that 71, but, will never know :( I really don't know what to tell you about dosing, except skip, and start new when you get back from the vets, I'm sorry I cant help you more, I hope Spike gets better soon. Maybe getting that depot down some would help him and rebuild from there?
     
  6. Cindy&Taco

    Cindy&Taco Member

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  7. Cindy&Taco

    Cindy&Taco Member

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  8. DevilPup

    DevilPup Member

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    Jul 10, 2018
    I offered some HC treats, he didn't want to eat them at first, but did. That is another warning bell to me. He may have gone lower than the 71, I agree. After the food he went back up to 106, so we shot him .5U. He seems very congested today. It is his rhinitis. He did go down to use the litter box and tested NEG for ketones. He is tested at least EOD for ketones, mostly everyday. He is in his box with the vaporizer on. That helps some when his sinuses are giving him problems, which is often.
     
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  9. Cindy&Taco

    Cindy&Taco Member

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    Oct 21, 2017
    how long till your vet appt? Since you have shot, even a much smaller dose, you can feed him more LC if he wants it and retest,he most likely went lower if he's sluggish, give him food a little at a time. He'll most likely rise quite a bit, but, better to deal with that than a hypo.Try and test him every 30 minutes, until he's risen enough for you to feel comfortable. When they go low , alot of times they are NOT hungry, keep that in mind :)
     
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  10. Joanne&TinySole

    Joanne&TinySole Well-Known Member

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    Jun 19, 2018
    Skip. When in doubt skip, or shoot late and slowly walk back your shoot time. Best to be cautious.
     
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  11. Cindy&Taco

    Cindy&Taco Member

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    Oct 21, 2017
    I tried my best, She gave a .50 instead of 2, and he's rising, hopefully Lu will keep us updated on spike. I think he will be ok till his vet appt.
     
  12. DevilPup

    DevilPup Member

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    Jul 10, 2018
    We dropped him considerably. And we shot late-1 hr late. After testing him showed increased values, we shot lower, much lower. I gave him only .5U. (from 2U) He is in the steambox now. We will be leaving for his U/S in 45 minutes. I will take all my supplies with me to vet. Karo/food in syringe/HC food in can/testing equipment. I won't be leaving him. We will be in the room with him during his test. I know, what a rotten day for him to have to deal with that now.

    I will have to deal with the numbers today. I will drop him tonight at PMPS, too to maybe 1.5U from 2.0, unless someone else can guide me better. Thank you again.
     
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  13. Cindy&Taco

    Cindy&Taco Member

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    Oct 21, 2017
    You may have to deal with high numbers for a few days, don't despair ;) Someone more knowledgeable will have to let you know what a good dose for Spike is to start back on, personally I think 1.5U is too much right now, but, what do I know ? :) Good luck with Spike today, I hope you get good news!!Dont forget to get those +11s in :)
     
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  14. Joanne&TinySole

    Joanne&TinySole Well-Known Member

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    Just continue to monitor him closely. A token dose may or may not be tolerated.

    @Jill & Alex (GA)
     
  15. DevilPup

    DevilPup Member

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    We are back from the Vet. His U/S went well. He actually fell asleep a few times. He is such a good man. My husband and I were in the room with him, I helped hold him and cradled his head in my hand while Doc did her thing. They are super there, that is why I like to get my U/S with her. No anesthesia, you're in, you're out.

    I tested him right before we left +1.5: 118; when we got there +2: 84 (got nervous) fed him HC wet and HC dry which he ate. Had U/S. Tested again: +3: 106. We left for home-20 min ride. Tested again +4: 154. I don't think he can eat another bite right now. He is currently relaxing. He did real well. Not too fond of the car ride, but both doors of the cat carrier are open and his constantly being scratched.

    Pancreas showed nodules of inflammation, which Doc said was much better than the entire pancreas being inflamed. We talked about the BETA cells and insulin. Kidneys looked good except for the right one which has some scar tissue on it (we've been told this before), liver was perfect. Gall bladder bile duct looked a bit inflamed. Bladder and intestines looked great. She was quite pleased with what she saw. She was also quite impressed on how his diabetes was being taken care of. Of how he was being tested (easy), that he WAS being tested and how we care for his other illnesses.

    I know I will need to drop him tonight. I just need help in determining what to re-start him at. I have updated his SS to show all the readings up til this point.
    Four days on his highest level, 2U, and the depot spilled over, put on the breaks and said enough. I knew he was going to drop fast, I just wished he would have given just a small hint. He will have to be tested more during the night....I don't sleep anyway.

    Hoping to hear from some with more knowledge and experience on a re-start dose. Thanks. :cat:
     
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  16. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    Dec 28, 2009
    Others may not agree, but I would have simply skipped this morning's shot what with going to the vet and all. I like to keep things simple and uncomplicated whenever possible. Numbers are simply numbers and if you've seen them once, you'll see them again.

    That said, I do understand why you've shot... wanted to give some insulin. As far as dosing tonight, he's definitely earned a reduction to 1.75u if following SLGS. Continue monitoring today. See how this all plays out... not just the numbers. Another consideration when it comes to dosing is whatever else is going on with the cat... in this case, congestion/asthma.

    Hope your vet visit goes well and Spike has an uneventful ultrasound!

    And you're back! LOL!
    Happy to hear the U/S went well! Like I said above, see how this plays out. I wouldn't be in any rush to make a dosing decision at the moment. What time is shot time (12 hours after this morning's shot) and what time zone are you in?


    ETA: If it's at all possible, please get a +10 or +11 so you'll know where the PMPS number is coming from.
     
    Last edited: Dec 5, 2018
  17. Bellasmom

    Bellasmom Well-Known Member

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    Feb 12, 2018
    Beautiful start
     
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  18. DevilPup

    DevilPup Member

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    Jul 10, 2018

    Since we shot 1 hour late this morning while waiting for his number to increase (7:00 am EST), I will probably shoot 15 min early (so 45 mins after usual) at 6:45 pm EST. I am in New York State USA. Last test was at +5. He is sleeping now. I will test again at +8 (2:00 pm EST) and again at +10 or +11. With the depot appearing full, I was hoping to drop him to 1.5 even though SLGS suggests a decrease of .25 (to 1.75) only. He dropped pretty low for my liking today and it seemed like it was a bit of a fight to get him back up there. I don't want that to happen again. We didn't have to do the Karo syrup...but it was out on the counter and in my bag at the vet. But I will shoot him at 1.75 if that is the best option and continue to test throughout the night.

    He got the steam this morning before his appointment; rode in the car (adrenaline also helps his congestion) and gave out a bit of gunky sneeze at vet. So hoping this clears him out for a bit. Thanks.
    Thanks.
     
  19. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Feb 28, 2012
    Here's the link to your previous post: http://www.felinediabetes.com/FDMB/threads/requesting-help-figuring-this-out.207447/
    As we thought, Spike sure told you what he though of this dose. :p Even though the numbers are lower than you are used to, he was still in a safe number range. I agree that 1.75 would be the new dose as per SLGS. But you did see the 60's on 1.75 before hand and didn't reduce.

    Glad the U/S went well. Too funny that Spike went to sleep. I prefer my vet cause I can be there too through the procedure. Did the vet say anything about the gall bladder duct inflammation?
     
  20. DevilPup

    DevilPup Member

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    Jul 10, 2018


    Yes, gall bladder duct inflammation goes hand in hand with the pancreas; as they empty out in the same "hallway." So if one is inflamed its going to p-off the other. That is why triaditis is so prevalent. Once the liver, pancreas, gall bladder become insulted/injured, it "spills over" and affects the other organs.

    Currently, there is inflammation in the pancreas so it inflames the bile duct. Once we get the pancreas to settle, so will the bile duct. I knew he was/is having pancreas issues again, but I wanted to ensure nothing else was hiding. Luckily for all of us, nothing is. We continue on with what we have been doing and just ride the wave. She suggested no other changes. We are feeding and medicating him appropriately. She was pleased on how he looked.

    We discussed his blood work and clinical indications. Even though his BGs may be ideal at some point, if he is still drinking/urinating/eating more, diabetes is still very present. How many times have we heard, "you treat the cat, not the numbers." However, with diabetes, we also treat the numbers....:nailbiting:

    He has really responded to the carbs today, knowing he would. I will drop him down to 1.75 tonight and continue to monitor. If he drops again below 90, I guess he earned another reduction. I don't have to wait "x" amount of cycles before dropping him again, right? As long as he goes below 90 again, he gets dropped again. That is a bit confusing as I try to wrap my head around the depot effect. It takes time for the depot to catch up with dosing (as indicated with me raising him). So wouldn't the initial drop tonight need to "run it's course" and register with the depot first; at least taking a few cycles?
     
  21. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    Dec 28, 2009
    Sometimes we'd suggest holding the dose rather than taking a reduction if the reductions come too quickly. That's because of what we call "the residual effects of the depot". That's just another way of saying there's a little depot action left on the dose which could help drop him a bit more than usual.

    That depot action lessens with each subsequent cycle after a reduction. It depends on the cat and some say size of the dose as to how long one might see action from the depot. With Alex, I learned/knew the depot from the higher dose was completely gone by the 5th cycle at the reduced dose do matter the size of the dose, but ECID.

    However, in Spike's case, the dose was greatly reduced this morning. That major interruption will cause the depot from the 2u dose to drain faster than usual. That simple action would lead me to believe the action of the depot would be gone sooner than later. BG meters are one of the best tools to have as long as you're monitoring! They'll give you all the information you need to keep Spike safe.
     
  22. Cindy&Taco

    Cindy&Taco Member

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    Oct 21, 2017
    I'm so happy you got a "semi" good report for Spike. :) It must have been difficult for you and your husband to try and finagle his low and get to the vet , but, it seems like you are both well aware of what your Spike needs.
    And you did a great job, although nerve wracking :nailbiting:

    I was in the midst of having my own dilemma with Taco , which isnt unusual ;) I hope I didnt pursuade you in any way to do something you regretted , I did advise you first ,not to shoot.

    I can definitely understand how you feel about the dosing changes, and wanting our kitties to get better quicker, but, I'm learning that I have to put the breaks on and sometimes do what I feel is best. Just always remember you are Spikes caregiver and you are the one with him all the time.

    It's taken me 2 years to come to those terms and probably looking at , at least 2 more.:rolleyes:

    I hope that I at least kept you company and gave you some kind of support in your hard time this AM.

    I am on the East coast, and am not available for support during the day as I sleep all day, because of our personal lives here in our home, but, I am always available during the night, East coast time for really nothing more than support and at least make you feel like someone is paying attention and at least cares a little :joyful: That is all I need in the group, at this time, and that's why I mention it .
    Take it easy , easier said than done :bighug:
     
  23. DevilPup

    DevilPup Member

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    Jul 10, 2018

    Please don't feel you gave me bad advice. I think most folks suggested I didn't shoot, but I decided to anyway. In decreasing the dose considerably I felt I was able to keep that depot somewhat "going" and pick up where I left off. I brought all my supplies and I was going to a vet's office. The Doc smiled and said...."like bringing your diaper bag with you." This Internist has her U/S practice set up with the Emergency Vets location. So I felt I was "covered." Further the tools are here to help us through.

    I really appreciate your message. It is terribly stressful when you need assistance and all you get is "crickets." Sometimes, all one needs is to "hash out" the situation with someone else who is knowledgeable and experienced (unlike my vet I recently dumped) to get them past the situation. But when no one answers, it is just awful. At least for me at this point, treating Spike is very stressful. While trying to learn what I need to know, Spike's numbers can be all over the place, depending on his other illnesses. It's hard to figure things out sometimes....is he going thru a flare? Is something else going on? Is he just tired, etc? Is he going hypo? There is a fine line between panicking and just trying to figure it all out. This illness is so very different than others I have treated in the past...it has serious consequences if you make the wrong decision. What do I do? What do I do?

    Honestly, for me being such a strong willed individual, your message brought a few tears to my eyes. All I could say was "that was so terribly sweet and thoughtful." I understand completely your own situations. And I would never point fingers at anyone here for giving advice even if it was the wrong thing to do. Because ultimately I make the decisions for my cat. We all just want to do right by them or we wouldn't be here!

    You did keep me company and made me feel I was not alone. That speaks volumes. I also appreciated the other messages I received. It did work out.

    He is riding low today, popped a "60" at +3, even though we dropped him. But I have to remember the depot. Even so, I will be watching today and may drop him again. He seems to hate the testing lately.....I wish there was another way. I try to get him when he is sleeping; seems to better for him.

    But thank you. I hope Taco gives you some peace and rides a nice comfortable green/blue wave.:bighug: I will reach out some evening, just to chat :) Please feel free to do the same.

    Lu and Spike :cat:
     
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