I am not sure what is going on. I will be honest I haven't been updating my spreadsheet daily, so I don't remember exactly what doses I gave. I am not sure when I gave him more due to at the time high BS reads. In the last couple of weeks they are all over the place. Note that I got a new tester. I don't like it because it take more blood, times out quickly, and doesn't beep. Has anyone else had issues with the Relion Prime Meter? I wanted to stay with Relion because of the economic. Is the Premier better? I appreciate all the feedback and I will keep better records of dosages in the next few days. FYI, there has been no changes in his food or eating habits. His overall behavior has actually improved - more frisky and now jumps on to the couch.
I'm sorry no one got to you sooner. I do think it would be good if you can gather some consistent info over the last few days, making sure you keep a note of what dose and when you shot. When you get a high Preshot number, you don't need to shoot a higher dose. In fact it's better if you shoot a consistent dose unless your kitty earns a reduction, which under slgs is if you catch a number under 90. On 2/23 you saw an 83 at pmps, that earned Tooters a reduction to 0.75u. You skipped that shot, which was the right decision since you don't shoot below 90 when doing slgs. However when he was high on the amps of 2/24 you then shot 1.5u (though from what you are saying you're not to sure since you haven't been keeping notes) you should have shot 0.75u at that point, tooters was high because you skipped and he 'run out' of insulin (the depot drained) and probably he bounced from seeing green. With lantus we look to how low the dose is getting kitty and we largely ignore the bounces, so there was no need to shoot 1.5, in fact you needed to let that 83 the night before guide your dosing decision, and you should have shot the reduced dose of 0.75u On 2/24 pm cycle you shot 1u and again he dropped to 83. Now with the inconsistent dosing it can make the numbers a bit wonky, so it makes it hard to know what the right thing to do is. Being inconsistent with the dosing is likely causing the numbers to be erratic, and not taking a dose reduction when it was earned may be resulting in him dropping low and then bouncing, which is why you are seeing low numbers one minute and then sky high the next. I would advise you to drop the dose to 0.75u, since that was a reduction that reduction was earned and not taking it, with your limited availability is risky, you run the risk of him dropping really too low. Also please try and ignore a high PS and just shoot the dose consistently, I know it's hard to see those red numbers. Looking further back he also earned a reduction on the 0.75u, but you didn't take the reduction then either, and you then instead took the dose up. How are you for availability over the next few days? are you able to get some midcycle tests in here and there? If you can I think that would be a really good move, because given the missed reductions I am worried that it's possible he's on too much insulin, even if you drop to 0.75u. With slgs you want to hold the dose for a week, unless they earn a reduction by a drop below 90, at the end of that week you would run a curve and look at the nadirs to help you to decide what to do about the dose. here is the instructions from the SLGS sticky Hold the dose for at least a week: Unless your cat won’t eat or you suspect hypoglycemia Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately. After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments. If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit If you could post a condo a little more regularly we can perhaps help you with any questions or doubts on dosing you may have. I looked back through the some of the old posts and I know at times you haven't had much response, feel free to tag me by writing @Gill & George if you need help. Also if you don't get a response you can bump up the post by replying to yourself so that your post goes back up to the list. Sometimes if it is busy and it drops to the bottom it can get missed. Another tip if you have a question and/or need help use the ? prefix from the drop down list, many of us will scan for those as it highlights which members are needing help. If you have questions please ask.
Thanks for the info. Yes I had gotten lazy with the tracking since he was doing good. Thanks for the clarification about high does. I get freaked out when they go so high. I guess I need to trust that Lantus works. I will move him back to .75. My schedule is pretty busy with working and no days off. But I’ll try to get some mid cycle tests.
We all get freaked out by those high numbers, just remember it's the lows not the highs that govern the dosing decision. Good plan, post up with your progress or if you have any questions/frustrations with how he's getting on.
I think you need to review all the informational stickie notes in the Lantus main thread and find a consistent routine you can follow. It's also best when your new to make this site a daily part of your routine so you can get help and explanations as to what is happening and why.
Gill provided some great information. What may help is to always remember that Lantus dosing is based on the lowest number in the cycle and not on the pre-shot number. There's a great appeal to give more insulin if the pre-shot number is high. In fact, this is the way shorter acting types of insulin work. However, Lantus is a long acting insulin with a depot. Given your work schedule, it looks like it's hard to get curves on a regular basis. One of the things I saw with my kitty was that Gabby could have a pre-shot number in the 400s, drop into the 40s at nadir, and bounce back into the 400s by the next pre-shot. If all I was paying attention to were the pre-shot numbers, I would have increased her dose. The nadir told me she needed a dose reduction. Any data you can collect will help you to have more of a clue as to what is going on with Tooters numbers. Getting a before bed test every night will be very helpful since many cats experience lower numbers during the PM cycle.
I appreciate all the help and information I learn from the Board. I don't know how anyone does it without your help - the vet says just to give a shot and see them in a couple of months! I will slowly get this stuff figured out. I see what you mean about how the pre-shots are not the full picture. I can't get many true mid-shots at +6, but I will try to get more +9, +10 numbers. Today was a good example of drops (amps 360, +9 79). His pmps was 100. I couldn't give shot because he didn't eat, but daughter retested 2 hours later and was 170 and gave the .75 Thanks for everyone's help and patience as I get this figured out.
What dose did you give this morning? What was his BG? the SS is not updated. As Sienne said tomorrows shot will need to be 12 hours from when your daughter shot, you can claw the time back by bringing shot time forward 15min per cycle. When we say midcycle we mean anything from +1 to +11 all data is useful. That would be good as it will tell you what direction his BG is heading when you get the PS, that can help you decide whether it is safe to shoot. I'm glad you took him down to 0.75 at pmps.
Sorry haven’t updated Sa since I have only had my phone to use. Yesterday Tooters was 100 at 5 but wouldn’t eat. My daughter got home at 7:30 and retested He was 170 and gave shot. This morning I had to be at work at 6 so tested and gave shot at 5:30. Don’t exactly remember his number but it was 300 something. Gave .75. Question- so how do I handle this type of work schedule? I am retail manager. My schedule varies. Typically I work 6am - 2:30pm and have the rest of the day free. But I can also work 8-430 or 3-11:30pm. For example today I worked at 6am but tomorrow I work at 3pm. I normally don’t have anyone else at home to help with testing. Suggestions? I have been just testing and giving shots the best I could. That is why I had always focused on Preshot numbers
That sounds really stressful to figure out!!! I hope someone can help. But I had to say that I ONLY use my phone and I use the spreadsheet exclusively on my phone with no problem. Can we help you to get it working on your phone too? It really really helps everyone to help you, to have the spreadsheet going!
Yay! I love being able to update it on my phone. I was testing and updating from my bed all last night. Lol!
