Derek was 92 @ +13...

Status
Not open for further replies.
JohnZ

JohnZ

Member Since 2015
Hi

It was suggested that I move over to this forum- here's the the link to my last posting-

http://www.felinediabetes.com/FDMB/threads/derek-is-92-13-should-i-shoot-reduce-shoot.139709/

So -

Derek was 92 @ +13 this afternoon- decided to skip his PM shot... will probably give his normal 1 unit of Lantus in the AM... but not sure- any thoughts? Spreadsheet is up to date.

I need to know/learn when it's best to reduce/adjust the dosage, skip a shot, or not shot at all... and will not always be at home to test.

Some background information (from last posting)...

My job doesn't allow me to test during the AM cycle- I'm up at 1 AM- test, feed and shoot Derek, and leave for work by approx 2:30 AM.

Get home around 12:30 PM... just before the PM cycle.

It's off the bed at around 6:30 PM (if I'm lucky)... so any mid-cycle testing is usually done between 12:30 PM and 6:30 PM.

Weekends are a little better- but I'm not always at home.

Thanks!
 
Last edited:
Hi, John and welcome to you and Derek to Lantus & Lev land. It sounds like your schedule is challenging. You might want to think about a timed feeder so Derek will have food available while your away from the house.

If you've not already done so, you may want to read through the sticky notes at the top of the board. In particular, deciding on which approach to dosing you want to follow will help us to answer your question about whether to reduce the dose. With the Tight Regulation Protocol, doses are reduced if numbers fall below 50 on a human meter. With Start Low, Go Slow (SLGS), reductions occur when numbers drop below 90.

Please let us know if you have questions. The people here are very generous with their time and knowledge.
 
Hi John

We follow two different protocols here and with your schedule it looks like the start low go slow (SLGS) protocol is going to be the way to go. There's a sticky about the protocol at the top of this forum. On that protocol Derek wouldn't earn a reduction until he went under 90 (assuming that you're using a human glucometer rather than an alphatrack - if you could add the meter type to your signature that would be great) so I would hold the 1unit dose. If per chance you are using an alphatrack (which reads higher) Derek has earned a reduction. I would still hold the 1 unit for tomorrow AM since he's likely to be higher after the skipped shot but then drop back to .75 for the PM shot.

Are you a single cat household? With your schedule I also think it would be wise to invest in a timed feeder that way you'll be able to shoot lower numbers but leave appropriate (higher carb wet if necessary) food to make sure that Derek is safe - we'll teach you how. Lantus is a depot insulin so it works better at keeping a cat in normal numbers than it does at bringing them down from higher numbers. Which means that, in due course once we work out how Derek likes to dance, you will need to start shooting lower numbers.

To save yourself from repeating yourself about your schedule too often - people are going to be asking you about mid-cycle tests frequently otherwise - you can add those details to your profile and make a note in your signature that the info is there.

Your last curve looks like it was a bounce cycle so the sooner you can do another so we can see what this dose is doing the better, ideally you will get a curve in every week and as well as the preshot tests at least one more in the evening.

Welcome aboard :)
 
Hi and Thanks!
You bring up some good points... I do have a timed feeder... only thing is I also have 10 other cats! No way of even knowing if Derek is actually getting any of that food. I do leave a lot of food out for them before going to work- something like 5 or 6 cans (on paper plates) in addition to the timer. Don't think i could do the Tight Regulation with my schedule...?
 
Vyktors Mum said:
Hi John

We follow two different protocols here and with your schedule it looks like the start low go slow (SLGS) protocol is going to be the way to go. There's a sticky about the protocol at the top of this forum. On that protocol Derek wouldn't earn a reduction until he went under 90 (assuming that you're using a human glucometer rather than an alphatrack - if you could add the meter type to your signature that would be great) so I would hold the 1unit dose. If per chance you are using an alphatrack (which reads higher) Derek has earned a reduction. I would still hold the 1 unit for tomorrow AM since he's likely to be higher after the skipped shot but then drop back to .75 for the PM shot.

Are you a single cat household? With your schedule I also think it would be wise to invest in a timed feeder that way you'll be able to shoot lower numbers but leave appropriate (higher carb wet if necessary) food to make sure that Derek is safe - we'll teach you how. Lantus is a depot insulin so it works better at keeping a cat in normal numbers than it does at bringing them down from higher numbers. Which means that, in due course once we work out how Derek likes to dance, you will need to start shooting lower numbers.

To save yourself from repeating yourself about your schedule too often - people are going to be asking you about mid-cycle tests frequently otherwise - you can add those details to your profile and make a note in your signature that the info is there.

Your last curve looks like it was a bounce cycle so the sooner you can do another so we can see what this dose is doing the better, ideally you will get a curve in every week and as well as the preshot tests at least one more in the evening.

Welcome aboard :)
Click to expand...

Thanks- the meter is a Relion Confirm.

See my last reply- which I sent before getting yours.

Me tired- time for bed... good night... and thanks.
 
Happy to see you made it over here!

If you'll post daily (or as often as you can) the people here will be able to help you make those dosing decisions. One thing about this message board, you're never alone in those kinds of things!

Sleep well!!

Just an idea on your schedule (don't know if it'd work for you or not)....If you could shoot at 12:30am, that would let you get a +2 at 2:30am as you leave for work ...and overnight hours are when our cats usually go lower, so that could give you a warning when it would be more important to make sure he has access to food while you're gone...even if it meant putting him in a room by himself so you know he could get the food.

Then if you're home by about 12:30pm, you could test/feed/shoot and again, if you don't sleep until about 6:30, get a +2 or +3 and a +5 or +6 (sprinkle them around)

If that would work, it'd be really helpful in figuring out how Derek is doing and allow you to even do Tight Regulation (which gives the best chance at getting Derek into remission)

As long as you can shoot at about the same time, it's OK to occasionally be off by a few minutes one way or the other, so even if you didn't get home until a few minutes late from work occasionally, it's still OK to shoot most of the time.

Just something to think about!...and Welcome to the Lantus Forum!!
 
Just want to add my welcome. There are many people who work full-time, you just have to be a little creative. Getting a test in before you go to bed would be helpful in figuring out how low the dose is taking him. Getting more tests in on your day off will help too.

Many new members will post and ask for dosing advice if they think it might be time to adjust the dose, until they've learned how to see things on their own. Info always makes the most sense when it's in context. There are many experienced people here who will help you figure things out.
 
Chris & China said:
Happy to see you made it over here!

If you'll post daily (or as often as you can) the people here will be able to help you make those dosing decisions. One thing about this message board, you're never alone in those kinds of things!

Sleep well!!

Just an idea on your schedule (don't know if it'd work for you or not)....If you could shoot at 12:30am, that would let you get a +2 at 2:30am as you leave for work ...and overnight hours are when our cats usually go lower, so that could give you a warning when it would be more important to make sure he has access to food while you're gone...even if it meant putting him in a room by himself so you know he could get the food.

Then if you're home by about 12:30pm, you could test/feed/shoot and again, if you don't sleep until about 6:30, get a +2 or +3 and a +5 or +6 (sprinkle them around)

If that would work, it'd be really helpful in figuring out how Derek is doing and allow you to even do Tight Regulation (which gives the best chance at getting Derek into remission)

As long as you can shoot at about the same time, it's OK to occasionally be off by a few minutes one way or the other, so even if you didn't get home until a few minutes late from work occasionally, it's still OK to shoot most of the time.

Just something to think about!...and Welcome to the Lantus Forum!!
Click to expand...

Thanks- Happy to be here- sure glad you folks are here!

The schedule idea is something to think about- but these hours are brutal sometimes as it is. By the time my girlfriend gets home (she works kinda normal hours) I'm literally running on fumes and have very little time with her before having to go to bed.

Holding the shooting schedule to within a minutes is probably not possible... to many variables involved. I try to keep it within 30 minutes... on the weekends I may have to push it a little further apart (because we're not home) and slowly pull it back. Is this to much information?

Anyway- back to bed for a few hours (got up to test/feed/shot Derek)... will update the spreadsheet (and post) when I get up.
 
No such thing as too much information :) You do the best you can, keeping the shots within 30 minutes of time isn't too bad and if that's the best you can do that's the best you can do. Can your girlfriend test, or learn how to test too?

When you shoot late you do want to pull it back slowly - 15 mins per shot, or 30 mins on one shot for the day.

When you get home from work is there generally still a bit of food left over or have your furry family demolished the lot? Free feeding is no problem for diabetic cats but you really don't want them eating in the two hours prior to their shot so that you know that the BG test result you get is not food influenced.

It must be wonderful snuggling up with 10 kitties in the winter!

I notice that Derek was diagnosed in July last year but has only been on lantus since May of this year. Was he on a different type of insulin before that and if so which one, how many units and why did you change?
 
Winters are great- the cats are like big sleeping pills- at bedtime! :cat:

Most days the food is all gone- but others half is still left- with 11 cats (total)- there's no way of knowing for sure how much to leave out...

This also creates a problem with Derek not eating for 2 hours before his shot- if I get home at 12:30 PM (which would be the earliest)- I only have an hour or so until his shot- and no idea when he last ate.

Good point about not knowing Derek's history after he was diagnosed- here it is (I'll also add it to my Signature info)-

Started low carb diet only on 7/23/14 per vet, his numbers stayed in the mid 300's.

Started Humulin N on 1/3/15- nasty stuff! He was started at 1 unit twice a day- and was up to 6 units twice a day by 3/25/15 (per vet), his numbers were much worse (than low carb food only)- mid to upper 400's!

Derek went hypo 4/12/15 and ended up in ER!

The vet never mentioned home testing or the possibility of Derek going hypo... I had no cure what either were (at that time).

There I go again- too much information! :)
 
Last edited:
Vyktors Mum said:
Hi John

We follow two different protocols here and with your schedule it looks like the start low go slow (SLGS) protocol is going to be the way to go. There's a sticky about the protocol at the top of this forum. On that protocol Derek wouldn't earn a reduction until he went under 90 (assuming that you're using a human glucometer rather than an alphatrack - if you could add the meter type to your signature that would be great) so I would hold the 1unit dose. If per chance you are using an alphatrack (which reads higher) Derek has earned a reduction. I would still hold the 1 unit for tomorrow AM since he's likely to be higher after the skipped shot but then drop back to .75 for the PM shot.

Are you a single cat household? With your schedule I also think it would be wise to invest in a timed feeder that way you'll be able to shoot lower numbers but leave appropriate (higher carb wet if necessary) food to make sure that Derek is safe - we'll teach you how. Lantus is a depot insulin so it works better at keeping a cat in normal numbers than it does at bringing them down from higher numbers. Which means that, in due course once we work out how Derek likes to dance, you will need to start shooting lower numbers.

To save yourself from repeating yourself about your schedule too often - people are going to be asking you about mid-cycle tests frequently otherwise - you can add those details to your profile and make a note in your signature that the info is there.

Your last curve looks like it was a bounce cycle so the sooner you can do another so we can see what this dose is doing the better, ideally you will get a curve in every week and as well as the pre-shot tests at least one more in the evening.

Welcome aboard :)
Click to expand...

Posted a new post today (link below)... is this the correct way to do it? Need to confirm a reduction in dose for Derek's PM shot.

http://www.felinediabetes.com/FDMB/threads/06-20-derek-amps-331-4-270.139733/

Also- what do you mean by a bounce cycle (in reference to the curve I did)?

Thanks again!
 
No one got back to me...

Derek's PMPS was 238...

Decided to go with the 3/4 unit (instead of 1 unit).
 
Status
Not open for further replies.
Back
Top