7/7 Need help - UPDATE Should I give PM Lantus dose? SHOULD I SKIP DOSE AMPS 108

Zoots preshots have been declining consistently over the last few days. Should I skip this AM dose? I am worried he will go hypo by the way his numbers are declining. See SS

 

I did decide to skip the dose. Will monitor him through the day.

 

Are you following TR or SLGS? I would have given the shot but only if I was going to be home to monitor. Kitty eating well? Are you prepared for lower numbers (medium or high carb foods?) At some point you're going to need to be shooting lower numbers - after all that's what we're aiming for here. It's scary at first - but eventually you'll be shooting greens - as he gets closer to where he should be - in those nice green numbers.

 

I am home, and Zoot is eating well. Lots of energy. Clearly he is okay.

I am not on either TR or GS but I have a hypo kit here, with 4 cans of FF Gravy lovers on hand along with syrup etc.

Frankly, over the past few days, his SS numbers show a pretty consistent reduction and I have not been testing frequently because he is so difficult. I can manage the pre-shots with help. I will try to test more today to see where his numbers are going.

It is a weekend, and I have no place to take him if he was to continue to drop tonight. I am trying to be preemptive here. Will talk with my Dr in the AM as well.

 

It sounds like you're prepared and that's the very thing you're hoping for. Please take some time to read the stickies at the top of this forum. Instead of discussing with your doctor - who unless he's a feline endocrinologist - not a general vet - will be clueless as to next steps for getting your kitty to good numbers. Look at other spreadsheets and see the numbers of people who are shooting their cats with low blues and green numbers. It really helps if you can get a test at 2+ to see where he's headed...IF you are able to keep him going down your chance for remission is very good! And get ready for that ride down - yesterday you shot in the blues and he went up - but he could have gone back down later - would have been good to get another test later in the day just to see. And getting a test at night, at 2+ is needed to be sure he's not headed off into those low numbers. Often cats will go lower at night - they just like to do that...don't want to miss finding out when his nadir happens (his lowest number in the cycle). Without more testing it's hard to tell from his SS when that happens.

I know it's difficult but there are lots of tips and tricks to make it easier. How are you supporting his ear now to get the test? Are you using a warm sock or something else to hold it? Are you rewarding with a little treat every time you try to test - whether you're successful or not - always give a treat. I had a really difficult time getting Luci to cooperate - it took two of us several months to convince her we weren't trying to kill her - she was awful. She wasn't a 'cuddly' cat to begin with and for starters didn't like being held - it was pure torture for all of us. But now she comes when I whistle - often jumps right up on the counter and sits and waits for me! But that's now - and we had many a rough time getting her behavior turned around. It takes time and patience but soon you'll have the swing of it - and I hope you have a quick go at remission - it's what we all hope for - and you're going to have to shoot those low blue numbers in order to get him into the greens - let's hope it happens soon!!

 

If possible you need to be getting some tests in during the cycles to see how low the insulin is taking Zoot. Don’t forget the pm cycle as well. Even getting a before bed test is good.
It would be worth while looking at the 2 dosing methods and following one as it will give you direction.

 

I would have shot, you were gonna be home and seeing good numbers hate for kitty to go back up, you should decide which protocol TR or SLGS so we can guide you better

 

I will try to test at +2! He is generally quiet then and I might be able to do it myself. I use a warm sock to warm the ear, but I just use my finger to support it when testing. That seems to work. He gets a treat yes.

So I am sure I panicked this AM. Still what is done is done; no shot and I will monitor as closely as possible.

Thanks for your advice. Yes, I have read the stickies many times, the information it so much it is quite daunting.

 

Unfortunately I decided not to. Will see how he does today and will take it from there. I can handle yellows but a hypo on a Sunday night would be my worst fear.

I can't decide on which protocol we can do - I don't understand the differences despite reading and re-reading the stickies. It just doesn't sink into my brain.

 

Zoot!'s AMPS =108 (no insulin);
Zoot!'s +2 = 221 (he was a good boy and got a treat)

 

The main differences seem to be with SLGS you earn a reduction when going below 90 and make decisions to change the dose every 7 days. With TR you earn a reduction when going below 50 and make dose changes sooner than 7 days depending on what the nadir is. If you are not able to test a lot, it's better to do SLGS. Also if you feed any dry food we recommend doing SLGS.

 

Ah okay - so probably SLGS, I will re-read that stickey note. Thanks.

 

What I would suggest is that you look over the SLGS information as a dosing strategy and see if it's a good fit for you. SLGS asks for less aggressive monitoring since it's a less aggressive dosing method compared to TR. It's helpful for you to have some parameters for when to increase or reduce a dose. It's helpful for us to know what you're doing so we don't plague you with obvious questions and can provide relevant information and support.

To summarize the difference between dosing methods, as I noted, TR is more aggressive. Numbers need to drop below 50 to warrant a dose reduction. Because the reduction point is lower, you need to be able to test more frequently. (The dose reduction point with SLGS is 90.) With TR, you are encouraged to "shoot low to stay low" - in other words, most of us who follow TR and are not completely new at managing their cat's diabetes, will shoot any number above 50. (SLGS doesn't require shooting this low.) With TR, most of the time you hold the dose for 3 days prior to increasing. (With SLGS, you hold the dose for a week prior to increasing.) SLGS does allow for a bit more flexibility. TR is a protocol that was developed an tested with cats from the German Lantus forum and published in a leading veterinary journal. SLGS pre-dated TR and was the approach that was used here. Both have solid data supporting getting a cat into remission.

 

I agree, it is daunting...I found it overwhelming as well...I felt like I was in information-overload every day...trying so hard to understand what to do and struggling to test Luci...I was a mess, I have to admit! But with each passing day I picked up another particle of information that actually stuck and made sense...like no dry food, and using the warm rice filled sock to support her ear when I did the poke - otherwise I was poking my darn finger! And I discovered that she found the warm sock soothing when I used it to stroke her back a few times once I wrangled her onto the testing towel...it seemed to help calm her and every now and then when I'd rub her with the warm sock - what's that sound??? a little purr would escape! OMG - she likes the warm rice filled sock! And now she purrs through the whole testing routine...but that was the early days - every test was an ordeal - I dreaded them - but I pushed on - every time I thought about the alternative - I figured it was this or let her die - and I just couldn't do that...so please try to hang in - it'll come, I promise! You'll have bad days and good days and you'll make mistakes...but at least you're trying to help your kitty - and that's the most important thing of all.

Hang in there - read the stickies - focus on what the others have said to you and move on. If you can print out a few of the stickies - like the one on handling a hypo - if you don't have something sweet on hand like karo syrup, honey, etc. go and buy some today - get some high carb and medium carb foods too - check out Dr. Lisa's list of carb foods so you'll know which ones to buy - mark the cans on the bottom with a sharpie as to the percentage of carbs and be sure to keep them in a separate area - don't want to go feeding him the wrong food by accident - and get yourself an extra supply of test strips - and even an extra meter if you can - nothing like that panicky feeling of needing to test frequently cause kitty is heading down and running low on strip - I keep a backup supply of 300 strips at all times - as soon as I break into my box of 300, I order another box - strips go fast. I've even had my meter poop out on me at the most inconvenient times. So it's a really good idea to have a spare - and batteries too - in the back up box/drawer. It just gives you peace of mind to have some of this stuff on hand - you may never need it - but it'll save you if/when you happen to.

Take today to look at other people's condos and their spreadsheets - look to see how others have managed hypo's and high numbers - we've got it all.

And most of all - breathe! Today is a new day - and tomorrow will come whether you want it to or not.

And one last request please: tomorrow when you post if you could format it like this: 7/8 Zoot AMPS ### - if you have a question, pop it right in there - and use the '?' icon like you did today. We'll be looking for your post tomorrow - best on those numbers today - if they continue to go up, you might as well take a break until after his shot tonight - then get in at least a test or two to see if there's any impact...

 

Agree. This is how I'm doing with Biscuits. I shot at 97 today. Scary but I'm around to test and feed. It's about being comfortable with dosing! We're on TR

 

Thanks - I printed the hypo stickie and have it on our cabinet near our "hypo kit". I will read the rest, and thanks for the hint on how to post my subject. Will do that. Here is where we are today so far.....

Zoot!'s AMPS =108 (no insulin)
Zoot!'s +2 = 221 (he was a good boy and got a treat)
Zoot!'s +4 = 200 (he was a good boy and got a treat)

I am just happy that I was able to check twice so far today! Will definately try the +6 to get the nadir.

 

Well look at you guys!!! He’s going down too!!! Good for you both

 

This might help
I use one of those square make-up pads to support his ear when I test. It comes in handy if you hit a vein & it bleeds too much.
Think of the SpreadSheet like a puzzle. The more spaces you fill in, the more you'll learn about how the insulin works at different times of the day.It seems most of our kitties BG goes lowest at night.
It will get easier for both of you Take a few deep breaths & try to be calm when you test. Our animals feel our emotions. The calmer we are the better for kitty !
Looks like you're off to a good start!
YES! The information is overwhelming! Take baby steps,a little at a time. The more you know & understand how the insulin works the easier it will become to help Zoot.
I printed out some of the info & keep it by my computer to quickly refer to if needed. You can also learn a lot looking at other SS (spreadsheets) & reading other condos.

Good luck to you!

 

@JoyBee&Ravan @Bellasmom @carfurby

Hi All!

Zoot! has been extremely cooperative today and I have taken reading every couple of hours.

Here is my question: I skipped the morning dose, and he has been in the 200s ever since. Do you think I should go back to the full 1.5 unit dose this PM? He looks great and is active and doing what he always does.

Cinnie

 

Yes he hasn’t earned a reduction yet... steady consistent dosing works best with Lantus.

Here's what @Sienne and Gabby (GA) "Numbers need to drop below 50 to warrant a dose reduction. Because the reduction point is lower, you need to be able to test more frequently. (The dose reduction point with SLGS is 90.) With TR, you are encouraged to "shoot low to stay low" - in other words, most of us who follow TR and are not completely new at managing their cat's diabetes, will shoot any number above 50. (SLGS doesn't require shooting this low.) With TR, most of the time you hold the dose for 3 days prior to increasing. (With SLGS, you hold the dose for a week prior to increasing.") said in an earlier post - based on which protocol you're following - you may even want to be thinking about an increase, but please try not to skip shots if at all possible - if not today, then tonight he'll be soaring into those higher numbers - not where you want to be at all.

 

Totally agree

 

Since you didn’t shoot today, and he’s not dropping down low, you can stop the testing until PMPS time. You did gather some good data, so good job. With what you have practiced today, may be you can get a +2 in the PM cycle tonight. The +2 test often can give you a heads up what the cycle will look like, and whether you will need to monitor more, or leave out higher carb food for him to eat.

 

Thanks All! His PMPS is 203 and I did administer his full 1.5 unit dose. I will definitely get the +2 tonight. All of a sudden it is like he will accept the testing. It is a godsend. Let's hope it lasts!

 

I'm glad he is letting you test. I always make it a good time for Furball and give her lots of loving and treats after I test, or food if it is AMPS or PMPS time. Good job shooting.

 

Zoot is co operating with the testing & his SS is looking better already! YAY! Keep up the good work!