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Help with the dose, please! SLGS, Porto amps +11,5 = 77. Do I shoot? A lower dose?

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by Manu & Porto, Aug 21, 2018.

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  1. Manu & Porto

    Manu & Porto Member

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    Apr 14, 2018
    He has been dropping these last two nights, I know even tho I didnt catch the numbers yesterday, he was cold and very hungry, towards the morning.
    This morning he is hungry again, dropping and this time I can see these low numbers.

    Do I shoot?
     
  2. Shawna & Davidson (GA)

    Shawna & Davidson (GA) Well-Known Member

    Joined:
    Jan 6, 2014
    The SLGS method states not to shoot if under 150, so I would not shoot. Many even on the TR do not shoot when they have a 77. You can wait 15-20 min and retest (no food) and see what he does but with the 77 you are safe not to shoot. i tlook slike you've done 2 reductions in the past day already so hold my suggestion is to hold off and test as usual until next shot time.
     
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  3. Manu & Porto

    Manu & Porto Member

    Joined:
    Apr 14, 2018
    Thank you, Shawna!
    I had to give some food now as he dropped to 77 and is asking for food like crazy. I held it for as long as I could but am worried he will drop more and want to keep above 90.
    Do you think is alright if I shoot 1 unit? During the AM cycle his budesonide is acting and his BG will grow a bit. I think, as lately he is full of surprises :D
     
    Last edited: Aug 21, 2018
  4. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    May 18, 2016
    I would not shoot a 77. There is very little room to work with. And very few members on the forum at this time to help.

    If you have already shot, you will have to monitor very closely. It is important to get a +1 and a +2. Do bear in mind that these numbers will be food influenced and that food will wear off necessitating the need for further testing as the cycle plays out.
     
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  5. Manu & Porto

    Manu & Porto Member

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    Apr 14, 2018
    I didnt shoot yet, 20 minutes left. Thank you for the advice, by now I decided not to shoot his dose, thats a certainty. Already gave a bit of high carb food to help him stay above 90.
    Is it better to hold all the dose for this am or maybe I can give a lower dose, just for him to have smth and not go really high in the next cycle?

    Thank you again!
     
  6. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

    Joined:
    May 18, 2016
    Glad you are not shooting. You likely do not need to give high carb food. High carbs are used for the scary cutoff number of 50.

    With high carb on board, you won't be able to get an accurate idea of how the cycle is going to play out. If the numbers go high, it might be a bounce due to the cat's natural reaction to unusually (for the cat) low numbers, or it might be because of the higher carb food.

    Do take a few tests just to gather data. The data could help you another time.

    I'm off to bed.
    Good night to me and good morning to you.
     
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  7. Manu & Porto

    Manu & Porto Member

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    Apr 14, 2018
    Thank you! I just gave a bit of carb but I will stop.

    I will test until I see the numbers raise a bit then Im going to bed myself :))

    Good night, Red and Rover!
     
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  8. Shawna & Davidson (GA)

    Shawna & Davidson (GA) Well-Known Member

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    Jan 6, 2014
    Sorry, I fell asleep as I've been up with Davidson and just vert tired trying to learn about RKD which both Harley & Davidson were diagnosed with.

    ** If you are stalling the dose, then don't feed anything and wait 15-30 min (depending on test number) and retest. If the numbers drop (according to the guideline numbers) don't shoot at all - not even a reduction, as this affects the depot for the next few days and you end up starting again and again with the cycles. I'm in the same situation with Davidson, so read his condo from yesterday and see the responses. Sometimes we get stressed or anxious and think it's better to reduce the dose and give 'something' then nothing, however that is not always correct. The depot is there for a reason and will fill and empty accordingly with each cat. If Porto was low with 77, no doubt he will drop further in 3-4 hrs with the insulin. Shooting at low numbers for newbies is difficult because you don't have the history or experience. Again, I don't know everything but have a great amount of experience with low numbers since Davidson goes there often and rebounds quickly. He also does well on low numbers and even though he's been in the hypo stages, he shows no signs at all and I'm with him every minute no matter how long it takes. Any appt. I have can be cancelled and I'm retired so have the flexibility and unfortunately many of you on here don't.

    For that reason the guidelines and different methods are there. READ all the yellow stickies several times, cuz even experienced CG's forget, and like you when an incident occurs we too get antsy!! When you don't get a response then my suggestion is don't shoot as better to be SAFE, and the depot will take over. Shooting at low numbers with nobody around will cause more stress if you don't get the replies, and could be detrimental to your kittie and giving HC food and testing until you see increased numbers is the right thing to do :bighug:
     
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  9. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    With a lower than expected pre-shot test, when using SLGS, you have 3 options:
    • Skip the shot
    • Shoot a reduced dose
    • Stall (do not feed), wait 15 - 20 min and retest. Repeat this until you see numbers rising.
    There are pros and cons with each option. With skipping and shooting a reduced dose, there's an impact on the depot. With stalling, your schedule needs to have the flexibility for you to shoot 12 hours from the time you shot.

    The "rule" regarding skipping if numbers are under 150 is not written in stone. Ultimately, you want to be able to shoot progressively lower numbers. Shooting lower numbers typically results in a flatter curve. In addition, when you skip, numbers typically rise making it more challenging to get your kitty used to spending time in normal numbers. However, you need to be confident with shooting those lower numbers as well as be able to monitor so you can see how your cat responds.

     
  10. Tracey&Jones (GA)

    Tracey&Jones (GA) Well-Known Member

    Joined:
    Dec 12, 2016
    Wow, a breakthrough! Looks like Porto is on a mission.

    I agree with Sienne. You want to be able to shoot these numbers and keep your dose the same and consistent. The 150 is for new members until they get comfortable with shooting lower numbers, have the data to understand what their kitty will do and so an experienced member can hang in with you to make sure things are going to go ok.

    You will be shooting those greens before you know it!
     
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  11. Shawna & Davidson (GA)

    Shawna & Davidson (GA) Well-Known Member

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    Jan 6, 2014
    Correct.........that is why it is very important to read all the info available in the yellow stickies, and from those who have the experience in the different areas. Several on here know both methods, some know only what they are on and it is up to US to learn about our method and act accordingly. Sometimes we make the wrong decision but at the time it is the right one given the circumstances. I did that last night, perhaps could have reduced according to some more knowledgeable them me, but I decided to shoot the full dose..........there often is not one right way, it is what we are comfortable with cuz there are choices.

    I am happy it is working out and you are getting great info for Porto
     
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  12. Manu & Porto

    Manu & Porto Member

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    Apr 14, 2018
    @Shawna & Davidson @Sienne and Gabby (GA) @Tracey&Jones Thank you so much for your insight! We have been through some lower numbers before and yes, as you get through them, you get more confident in shooting higher dose, having the previous numbers with the lowered dose from before, help you. This morning tho it was a bit too low, for him, he doesnt usually have any big drops, without reasons I later identify (I think and hope!), like vomits or loose stools or him not eating well. I think he had another drop the other night, cant know for sure because I didnt test :banghead:

    He had changes to the dose, increased, from 2 to 2,5 a bit after starting with budesonide and we also changed the diet, then, to mostly wet low carb. I know you are supposed to stop giving insulin for 24 hours, do a curve and redose, after going into the low carbs diet. Im not sure if this wet diet qualifies for that situation, the wet he receives now has 7% carbs and before he used to receive 20% carbs wet. A week ago, we also started going outdoors and moving, walk, for 30 min every day. He used to lay all the time. Also, he is receiving a lower dose of budesonide in the last couple of days.
    So all these changes, I think in retrospect, I see the yellows and the blues and think that maybe we shouldnt have upped the dose with 0,5 at the same time with these changes? He is almost 400 now and in two hours it is pm shot time.
    I have no idea what to shot. Stick with what dose? Was thinking of going back to 2 ud but dont want him stuck into the reds again :(
    Any insight for us would be so helpful. Thank you so much!
     
    Tracey&Jones (GA) likes this.
  13. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    Low carb is considered below 10% carb. High carb is over 15%. So, Porto is on a low carb, canned food diet.

    If you are following SLGS, then when numbers drop below 90, you reduce the dose by 0.25u. It looks like you previously were making dose adjustments in 0.5u increments. We use a smaller amount when changing doses. You don't want to make a large change in dose since you can go right past what would be a good dose.
     
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  14. Manu & Porto

    Manu & Porto Member

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    Apr 14, 2018
    Thank you for the advice, Sienne!! Then Porto is on a low carb, canned food. Good to know, it was not easy getting here with his IBD and kibble addiction.
    We increased with 0,5 due to starting the budesonide treatment, I will stick to 0,25 otherwise! :):bighug:
     
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