? 5/29/18 Leo AMPS 7.0 (126. USA) Need Advice please

Discussion in 'Lantus / Levemir / Biosimilars' started by Sonia & Leo, May 29, 2018.

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  1. Sonia & Leo

    Sonia & Leo Well-Known Member

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    May 24, 2018
    We increased his dose last night from 4U to 4.25U. No good numbers during the night but 7.0 (126 USA) preshot. What do I do?
     
  2. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Sorry no one helped you out earlier. Stalling until you got a number you are OK with shooting is an acceptable option. It does mean your PM shot should also be 1.5 hours later. You can move back on schedule either 1/2 hour once per day, or 15 minutes per shot.

    Over time and as you gather data, you will be able to shoot lower numbers. I see you shot a 146 this last week. However, if you do shoot lower, I highly recommend doing so when you can monitor that cycle. I don't see very many tests at night, bu t that is often when cats go lower. Getting a before bed test is a good one.

    Looks like Leo had a pretty good day by the numbers today. :cool:
     
  3. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
  4. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    I always agree with Wendy. Some additional info.

    Some cats do go lower at night. For my Leo - we generally dose him
    4.0 units AM
    3.0 units PM

    He almost always goes lower at night. Yes I should keep up my spreadsheet as an example, but it's almost always the same numbers. And as I have said on a recent post, even with a 3 year treatment plan like my Leo, testing is still important. He had a hypo last week and we caught it because we still test multiple times every day.

    So it may be that you end up dosing your Leo in a similar fashion. Testing and mapping the trends will be important.
     
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  5. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    You might want to read the Sticky Notes on this forum. People usually pick one of two dosing methods, either Tight Regulation, or Start Low Go Slow. For people following those dosing methods, we find it's best to give the same dose in the AM and the PM. Due to the nature of the Lantus depot, what you dose in the AM can impact the PM cycle and vice versa. Dosing higher in the AM can give you lower numbers in the PM.
     
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  6. Sonia & Leo

    Sonia & Leo Well-Known Member

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    May 24, 2018
    Thank you Wendy, Sorry for the confusion of two posts. When I created my first post yesterday morning, I got a "unexpected database error, please try again later" msg. I assumed my post didn't work so I kept trying and was able to post a little while later, so hence the two posts, didn't mean to do that, really! LOL

    Please take the info from Leo's SS before May 3rd with a grain of salt. We were taking dosing, and BG tests advice from our vet and it was pretty much a "blind leading the blind" situation. On May 4th in the PM, we started over with 2U BID because our vet thought we may have missed the ideal dose, at this point we were on our own because we didn't feel confident with a lot of things our vet told us to do. We've since been doing the dose increases in the PM.

    If I understand correctly, a dose increase in the AM will affect the BG's in the PM and vise versa?
     
  7. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    Since you are on Lantus, that is a "depot" insulin. You probably want to read the stickies and how Lantus works. In short it forms a depot that tapers off around 12 hours but some is still active past 12 hours.

    Dose increases affect the immediate 12 hours and also affect the next dose as well. That is why we recommend small dose increases. They are consistent, plus we can see the effects over a period of a few days.
     
  8. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    It's not quite that simple. Cats don't like to follow the rule books. :cat: Dose changes in the AM can impact the AM or PM cycle or even the cycle after that. One of the ways to think of the depot is a little tug boat moving a big tanker ship. Little change (pushes) may have a delayed impact on movement.
     
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