Big problem with shot time . Need help!.

Discussion in 'Lantus / Levemir / Biosimilars' started by dinu55, Mar 8, 2017.

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  1. dinu55

    dinu55 Member

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    After the last night injection, the blood sugar stayed above 300 all night until now in the morning. Now when the time came for injection, the blood sugar begins to drop. I do not know what to do.
     
  2. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Shoot, he's still at a safe level. He bounced over yesterday's greens and has come down a little way from the bounce. If you keep witholding food, he may continue to drop.
     
  3. dinu55

    dinu55 Member

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    Hi. It is on the decline. Fell from 230 to 196 in half hour..
     
  4. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Yes, I saw that on the spreadsheet. But he's still at a very safe number and it's OK to shoot a dropping number if he's that high up. If you can monitor today, I would shoot.
     
  5. dinu55

    dinu55 Member

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    I measured again and is 175
     
  6. dinu55

    dinu55 Member

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    When Babulica was 230, I gave food
     
  7. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    He is still at a very safe number. It is OK if he is coming down because that means the bounce is going away. If you can monitor, it is OK to give insulin. If you are worried, you can give him a little higher carb food for a second breakfast.

    It's bed time here, so I can't stay with you. But if you shoot, get a test 1 and 2 hours after the shot. It will be good data.
     
  8. dinu55

    dinu55 Member

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    ok, thank you
     
  9. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    Did you shoot? I will be up another hour or so, and can check on you every now and then.
     
  10. dinu55

    dinu55 Member

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    Hi, I gave 0.75 at +13
     
  11. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    Okay. I'll check back to see your +1 test.
     
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  12. dinu55

    dinu55 Member

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    Good. I'll post at +1. Thank you!.
     
  13. dinu55

    dinu55 Member

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    +1 98
     
  14. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    Sorry. I fell asleep. :oops:

    That was a big drop. Did you give some more food?
     
  15. dinu55

    dinu55 Member

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    No, only at +230 +12
     
  16. dinu55

    dinu55 Member

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    104 at +1:20
     
  17. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    He's coming back up, but I would give a little more food soon.
     
  18. dinu55

    dinu55 Member

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    Well, then I'll give him something to eat. I test again at +2
     
  19. dinu55

    dinu55 Member

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    It is normal to decrease so fast and so much at +14?
     
  20. dinu55

    dinu55 Member

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    There is another method to communicate faster?
     
  21. dinu55

    dinu55 Member

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    107 at +2
     
  22. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    That's better. At least he's staying fairly even.

    We don't really call it +14, since you have given another shot. It is a bit surprising to see such a big drop just an hour after giving insulin. But not abnormal.
     
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  23. dinu55

    dinu55 Member

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    I will check blood sugar again at +3. I gave to eat wet food (very low carbo). Must give something dried?
     
  24. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    I am sorry, but I am going to have to go to bed soon. It's after 2:00 am here and I just can't stay awake.
    The wet food is fine. He seem stable right now. Do you have any wet food that is a little higher in carbs?
     
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  25. dinu55

    dinu55 Member

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    If you look at the previous day you'll see the same decrease. At +2 was 237 and at +4 63
     
  26. dinu55

    dinu55 Member

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    Yes , I have wet food with high carbs.
     
  27. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    He likes his steep dives, doesn't he? But even though he bounces back up, he doesn't stay there long.

    I would give him a little more food. Since he seems to have levelled off, the low carb is fine. I was worried he was going to keep dropping, but so far so good. I will try to stay awake to see the +3. After that, there will hopefully be some more people on the Board as the East Coast US members will be getting up.
     
  28. dinu55

    dinu55 Member

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    Ok. Thanks for the help. :bighug: . I hope at +3 to be well. Anyway I will continue monitor Babulica today every hour.
     
  29. LizzieInTexas

    LizzieInTexas Well-Known Member

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    Aren't bounces frustrating? You will gain more confidence as you gain knowledge. The more data (tests) you can get the better you will know what to expect.
     
  30. dinu55

    dinu55 Member

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    Hi, I can not understand how the blood sugar began to drop at +12 . Until then what insulin did?
     
  31. dinu55

    dinu55 Member

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    +3 112
     
  32. LizzieInTexas

    LizzieInTexas Well-Known Member

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    Very nice! Maybe a bit more LC to keep him surfing. Not too much as you want him to eat incase he needs HC as he gets closer to peak (nadir).
     
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  33. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    I think he was bouncing from the low numbers he had yesterday - when the blood glucose drops really low like that and the cat's body is accustomed to higher numbers, the liver "panics" and releases stored sugars to bring the numbers back up to what it thinks is normal. As the insulin keeps taking the numbers down more often, the liver will learn that those numbers are not bad, and hopefully the "bouncing" will lessen. Bubulica's bounces are short, which is good, but it can keep you busy trying too keep up with him.

    @LizzieInTexas, can you hang around for a little bit?I really need to go to bed.
     
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  34. dinu55

    dinu55 Member

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    Good . He's sleeping now . Wake up Babulica to give little wet LC food
     
  35. LizzieInTexas

    LizzieInTexas Well-Known Member

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    I'll be around for about an hour.
     
  36. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    Good. Hopefully there will be others available by then, so @dinu55 can get help if needed. I think Babulica isn't planning anything dramatic today, but you never know.

    I'm going to go to bed.
     
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  37. dinu55

    dinu55 Member

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    In 42 minutes new blood test
     
  38. dinu55

    dinu55 Member

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    Sleep well and sweet dreams Tricia!.
     
  39. LizzieInTexas

    LizzieInTexas Well-Known Member

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    Get some rest :bighug:
     
  40. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    Thank you. I sent a message to some other veterans to check in on you after Lizzie has to leave. Babulica, please be a good kitty!
     
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  41. LizzieInTexas

    LizzieInTexas Well-Known Member

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    Waiting is the hardest part for me. I have to sit on my hands - lol.:rolleyes:
     
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  42. dinu55

    dinu55 Member

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    I do not like waiting too, but there's nothing I can do in this situation . + Tonight I do not know what dose to give. :nailbiting:
     
  43. LizzieInTexas

    LizzieInTexas Well-Known Member

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    Will defer to more experienced for dosing but it all has to do with the way Lantus works (depot). I still don't fully understand how it works but I just have to trust that it does. Think of the as a kind of slow/time release drug. When the old shot is wearing off the new shot is just starting to work.
     
    Last edited: Mar 8, 2017
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  44. dinu55

    dinu55 Member

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    +4 126
     
  45. LizzieInTexas

    LizzieInTexas Well-Known Member

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    Fantastic! He is safe and gradually climbing. Test in an hour and feed as usual schedule.

    I am getting ready to leave for work. I will check when I get there. (About 45 min)

    @Bobbie And Bubba are you around? I think Bubulica is fine, just don't anticipate to leave Without someone watching.
     
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  46. dinu55

    dinu55 Member

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    Good . I will do so . Thanks for your help. +5 next blood test. :)
     
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  47. dinu55

    dinu55 Member

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    +5 = 116
     
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  48. LizzieInTexas

    LizzieInTexas Well-Known Member

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    :)

    What is the normal feeding schedule?
     
  49. dinu55

    dinu55 Member

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    Today I gave him 4 times to eat. Starting at 9:30 AM. He ate 1 1/2 (approximately 120g food) Känguru exotic carny. Last time (fourth) I gave him food 10 minutes ago ( 3 PM)
     
  50. LizzieInTexas

    LizzieInTexas Well-Known Member

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    Is this every day "normal" feeding or just today?
     
  51. dinu55

    dinu55 Member

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    No, just today. Normal eating 5-6 times per day little by little. Babulica not eat too much.
     
  52. LizzieInTexas

    LizzieInTexas Well-Known Member

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    Feed as normal and just keep testing and posting.

    You will probably see higher numbers tonight due to the bounce from the lower numbers (this cycle) AND the reduced dose (0.75u) from this morning.

    tagging @Wendy&Neko for dosing advice.
     
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  53. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Hi there! I just signed on and caught up with your thread. Looks like he's in safe numbers. But I would get another test in around +6 to make sure he is holding these nice blue numbers
     
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  54. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Something to think about today now that he's in good BG numbers: have you read the information on this forum about the two different ways of giving Lantus? One is called TR (Tight Regulation) and the other is called SLGS (Start Low Go Slow). Are you following either one of these? If you were using SLGS you would drop the dose by 0.25 u immediately after getting the low green number yesterday.
     
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  55. dinu55

    dinu55 Member

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    ok , I asked Wendy&Neko about the dose. I was afraid to give 1.25u because it was on the decline :nailbiting:
     
  56. Kris & Teasel

    Kris & Teasel Well-Known Member

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  57. dinu55

    dinu55 Member

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    Hi
    I wanted to start TR. but his numbers not let me. So I decided to wait, to do some more tests....
     
  58. dinu55

    dinu55 Member

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    Hello . Of course I do test at +6. Until it begins to climb I'll monitor Babulica non-stop
     
  59. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I suggest you try SLGS then. It's a little less risky for BG numbers and might give you less worry and stress. Once you get accustomed to that method, learn more about how Babulica responds and become more comfortable with dosing, you can try TR. People sometimes go back and forth between TR and SLGS.
     
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  60. dinu55

    dinu55 Member

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  61. LizzieInTexas

    LizzieInTexas Well-Known Member

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    Remember - it is like time release meds - declining last shot when you are shooting current shot. I know it is scary but it really does work that way. As long as you can monitor (test) and Babulica (love the name) has an appetite and you can feed (and she will eat) you can steer her with food. It is important that you are consistent with the dosing so that you know what to expect and the depot remains relatively stable - this helps keep Babulica's numbers more stable (except for the bounces). :bighug:
     
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  62. LizzieInTexas

    LizzieInTexas Well-Known Member

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    Better than my Romanian :D
     
  63. dinu55

    dinu55 Member

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    :);):bighug:
     
  64. Kris & Teasel

    Kris & Teasel Well-Known Member

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    My Romanian is a mess - no one can understand me! ;)
     
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  65. dinu55

    dinu55 Member

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  66. dinu55

    dinu55 Member

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    +6 130
     
  67. CassAndGordy(GA)

    CassAndGordy(GA) Well-Known Member

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    Bubulica is looking good today! He is in nice blue numbers mid-cycle. I know the numbers can be a little scary, so if you feel more comfortable doing so, then keep testing.

    (I am not a veteran here, but I have been following your story so far. I also LOVE your cat's name... I think I've told you that before.)
     
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  68. dinu55

    dinu55 Member

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    Hello .
    Numbers do not scare me very much, but it scares me the way that Bubulica react to insulin Lantus. E.g : yesterday evening after injection he stayed at +300 all night. When I wont to give him the morning injection, glucose it began to drop sharply. :confused:
     
  69. CassAndGordy(GA)

    CassAndGordy(GA) Well-Known Member

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    Hopefully he evens out for you soon. With his recent history of Hypo and DKA, his body is trying to get used to the newer numbers. The sharp drops are concerning, but you're doing a really good job watching and monitoring him. After a little time, you and Bubulica will learn how to predict the numbers a bit more. Of course, every cat is different, and to be honest, every cycle can be different. Its a tough thing to learn, but the lovely people will be here to help through it all :)
     
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  70. dinu55

    dinu55 Member

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    Thanks for the encouragement. :bighug:
     
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  71. dinu55

    dinu55 Member

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    +7 113
     
  72. dinu55

    dinu55 Member

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    I gave to Bubulica a little food again, because of blood sugar mini-decline.
     
  73. LizzieInTexas

    LizzieInTexas Well-Known Member

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    Beautiful blue cycle. Keep up the good work!

    ETA - what you are doing is steering the cycle with food. This helps keep the bounces from being BIG bounces. Sometimes it works, sometimes it doesn't but it does keep kitty safe.
     
    Last edited: Mar 8, 2017
  74. dinu55

    dinu55 Member

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    +8 138
     
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  75. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    I got your PM, but we do not do dosing advice via message, so here are my thoughts. First if Babulica is on entirely wet food, you have the choice of doing Tight Regulation or Start Low Go Slow. The numbers he did today and yesterday were perfectly safe. If you look at some of the other people's threads and the numbers they have, you'll see lots of green numbers. If you are using Tight Regulation for dosing decisions, you would hold the dose at 1.25 units tonight bexause we don't reduce until kitty goes under 50. However, if you are not comfortable with those numbers, that's OK, you can use the Start Low Go Slow Method for dosing and reduce to 1.0 tonight. SLGS reducea by 0.25 units when kitty goes below 90. With SLGS you would then hold the dose for a week, do a curve, the re-evaluate the dose, unless he goes under 90 again, in which case you would immediately reduce.

    As for last night/today's cycle, it is possible for some kitties to get really long duration from the insulin. When my Neko was on Lantus, she used to occasionally nadir at +13. Today you had the added effect of the sugars from the bounce clearing out too, which made it look like a steep drop.

    I wouldn't be surprised if Babulica decides to bounce again tonight. He saw a brief flash of green, did a fast drop into AMPS, and then you gave a reduced dose this morning. All of these could mean higher numbers tonight. That's OK. The effects of a reduced dose can last a couple of cycles as the depot builds up again.
     
  76. dinu55

    dinu55 Member

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    Many thanks for the reply. I will think about of alternatives which you've written, and i have to take a decision .... what to do next. :bighug:
     
  77. dinu55

    dinu55 Member

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    128 at +9
     
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  78. dinu55

    dinu55 Member

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    Bubulica likes blue today
     
  79. dinu55

    dinu55 Member

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    127 at +10
     
  80. dinu55

    dinu55 Member

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    It looks like Babulica sit on blue. Remain valid what you told me if at +12 is still there?
     
  81. CassAndGordy(GA)

    CassAndGordy(GA) Well-Known Member

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    Nice Bubulica! Keep those steady low blues :)
     
  82. dinu55

    dinu55 Member

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    I do not know what to say..... in 2 hours I need to give the injection.....
     
  83. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Things could change in 2 hours but, if you need help, change your title to: Dosing Advice Needed ASAP
     
  84. dinu55

    dinu55 Member

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    Ok, thanks!.
     
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  85. dinu55

    dinu55 Member

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    I should look on amazon for new ears for Bubulica. :facepalm:
     
  86. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    That is funny and we can all relate.
     
  87. dinu55

    dinu55 Member

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    +11:30 next blood test
     
  88. dinu55

    dinu55 Member

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    +11:30 140
     
  89. dinu55

    dinu55 Member

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    I think to give 1u. What do you think, it's ok?
     
  90. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Are you able to monitor tonight and have plenty test strips and MC AND HC food?
     
  91. dinu55

    dinu55 Member

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    I can monitor it tonight, and I have all that need's + 150 tests
     
  92. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    I think 1 unit sounds good. The numbers could continue to rise due to bouncing from all the time spent in those nice blues today. So not to worry.
     
  93. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Try 1 u and do a test at +2. The + 2 test can give you an idea of what might happen in the cycle:
    1. If the +2 is quite a bit lower you might have an "active" cycle where you should monitor more.
    2. If it's about the same as the pre shot the cycle should be "normal" - not too much excitement.
    3. If it's higher than pre shot there might be some bouncing starting and you won't have to test much.
    These are general guidelines but very useful.
     
  94. dinu55

    dinu55 Member

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    Ok. thanks for the info.
     
  95. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Thanks Kris for adding all this good info. I am at the doc office and was brief.
     
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  96. dinu55

    dinu55 Member

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    After I give the injection. I have to change my title again, right?
     
  97. Kris & Teasel

    Kris & Teasel Well-Known Member

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    This is some of the great advice I got from the L&L pros here.:)
     
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  98. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    You can remove the title so people won't think you still need help.
     
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  99. dinu55

    dinu55 Member

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    All done, I hope to be a quiet evening. :)
     
  100. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Someone is around if you need help
     
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