? I need a quick response with Pooper's morning numbers!

I don't know what is going on but yesterday Pooper's has been going up all day with eating FF and the 5.5 units he got in the morning at around his normal time. Last night before I went to bed he went from 406 to 295 in +3 hours and this morning brace yourselves he was at 156!!!!!! He has not been that low with a morning number since December. What the heck is going on with him? I am not doing anything different other then giving him the 5.5 units of insulin. So my question is, since he is under 200, I didn't give him any insulin. If I have to give him any, what amount do I give him? I was leaning towards .5 to 1 unit. If not then I was just going to let it go an hour and then retest and if he is above 200 then give him 1 unit?? What do you guys think I should do?

 

It may be best if you can wait an hour to retest if that's possible. I can't say how much you should give - I haven't had a sugar cat in a long time.

 

Lantus craves consistency.......Since you've chosen to continue with the 5.5 unit dose, if you can be home to test today and have plenty of supplies if you need them, I'd shoot the scheduled dose of 5.5

I'd be sure to get a +1 and +2 to see how he's doing so if you need to intervene, you can do it sooner rather than later.

Remember, by shooting late, you're changing your shooting schedule for tonight....the next shot is 12 hours from this one, not at the regularly scheduled time, but you can work back to your chosen time 15 minutes per cycle or 30 minutes per day

The other option if your really concerned is to give a BCS (big chicken shot)...a one time reduced dose (like half) to give him some insulin, but not the entire amount.....but doing that will re-start the 6 dose "shot clock" but is the safest thing to do

I can't stay here to help all day today...I'm sorry. We will usually stay with someone when they first shoot a lower number than they're used to, but I just can't today

If he does drop below 50, edit your subject line and add the 911 to get more eyes to help you

 

Just in case he drops below 50, you should have this information...."Shooting and Handling Low Numbers"

 

I prefer not to give him a shot even at 1 unit if he is below 200. I'm worried since I won't be around all day that he would drop too low from this point. I'll probably not have to wait until tonight unless I check here shortly and if he is above 200 then I could give him 1 unit. I won't give him the 5.5 units if he is just barely above 200.

 

+1.5 hours he is at 236. So feeling I should give him perhaps 1 unit or 0.5?

 

please read this delicately.....

you are responding to the bg number and shooting insulin like it is caninsulin. With that insulin, you do react to the pre-shot number.

With lantus, the dose is determined by the lowest bg in the cycle. So you don't react to the pre-shot number and change the dose.
If you want to keep him in these better numbers, you need to continue with the dose you have chosen and Be Consistent.
If he drops below 50, ( and remember you are there to steer him back up) then he will earn a dose reduction and it will show you that
his dose is too high.

It would be better if you would post daily in the lantus forum where there are more eyes paying attention.
Eventually you need to shoot below 200, so that Pooper can at least get regulated.
The goal is to have all numbers under 200. right?

 

If you give him 1 unit, then his depot drains and you lose the momentum you've been wanting so badly.

and when you do that, you help his body get more resistant.
insulin resistance is a bugger....

 

I will not be here today to check his numbers if he does fall. SO I can't give him 5.5 units at 236 and worry that he really falls to dangerous levels when I can't be here this afternoon. what do I do?

 

okay.
then do the BCS, and give him 3.

and then try to put this in your mind, that depot is already built up and he is going to do what he is going to do...
it's like a train that's lumbering down the track.... so his numbers this morning are still in response to last nights shot.

it's like what you shot last night, is just showing up this morning....
so I try to describe it more like what you shoot, is what you see the next cycle....

monitor him while you are home....
and leave food out for him, even if you have to lock him up so you know if he eats his food....

 

Okay so give him 3 units and pray he doesn't drop to hypo levels knowing I won't be here to monitor. I have to leave in 3 hours

 

get that +2..... see if it drops significantly....
and if so, give high carb....

i'll check back in 2 hours.

there doesn't seem to be that many on site this morning.....

 

Well stupid me failed with this shot. I tried to give him 3 units and what I thought was a shot right into the skin of his neck line it squirted out from his hair again. I swear I thought I had it into his skin by how it felt when I put the needle in. So I have no idea how much got into his skin. I didn't reshoot this time like I did before so I'll just have to hope something got into his body and wait until tonight to give him his next shot.

 

fur shots happen....
i've been giving more myself lately....

 

That's frustrating! Sorry I don't feel qualified to offer advice yet, but just wanted to give support - I've been having more than my share of stressful numbers and doses lately.

 

Atleast I gave him a shot just don't know how much. Tonight he get his usual shot again and just go from there. It was nice to see 100s for his morning preshot which hasn't happened in like 5 months. Maybe heading in the right direction and dosage to help jumpstart his pancreas help him feel better.

 

Kind of late to intrude, but I did want to point out one important thing.

The "Shooting low numbers" sticky that you linked begins with this in big red bold font:

FOR LANTUS and LEVEMIR USERS following the TIGHT REGULATION PROTOCOL:

That statement is repeated a few times within the sticky itself.

Poopers is not on TR, right?

Would this be a better thread to link to?
http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

 

No he isn't. Following the SLGS method

 

Copying my response from your cross-post in the Lantus/Lev ISG:
http://www.felinediabetes.com/FDMB/...ooting-with-lower-number.136414/#post-1406816

I haven't chimed in on this for several reasons... mostly because I have to literally post and run.

• The OP is using the SLGS approach which means everyone offering suggestions/advice has to turn off their TR brains!
• The reduction earning point for SLGS is 90.
• The never shoot under number for SLGS is 90.
• The " Shooting & Handling Low Numbers sticky" does NOT apply to SLGS and says so in red at the top of that sticky.
• INITIALLY (with SLGS), the no shoot number is for anything under 200 (the typical no shoot number on the board). With SLGS, you want to gradually lower your no shoot number based on the data you've collected and the individual caregiver's comfort level. In other words, gradually lower the no shoot number using the data you've collected to support your decision. It's a gradual and methodical process based on the caregiver's availability and comfort level.

Circumstances which should have been factored into advice given today:

• caregiver is using SLGS method
• the current dose has not been reached in the manner we're accustomed to: small increments & consistent dosing (look at Poopers ss).
• the caregiver will not be around to monitor closely
• the caregiver is brand new to Lantus use and his data doesn't support much of anything at this point.

I've probably forgotten some good points. I'll add them when I get home if I happen to think of any. I guess the best advice I can give those who are offering advice to members following SLGS is to turn your TR brain off before replying. Believe me, I know how hard that is!

 

I know I've got a tr brain.....

Ryan had told me in the beginning that he wanted remission so I tend to lean that way with him and forget that he's
changed to SLGS.

 

You can still get to remission on SLGS, it's just a different path. It's not the protocol that heals the pancreas, it's the aim of getting them into healing numbers so the pancreas can heal if it is not too damaged. SLGS has been around a lot longer than TR, and plenty of cats have gone into remission with it.

The odds for remission should be better with tight regulation, if the protocol is followed as written, because the idea is to get them into healing numbers as quickly as is safely possible and then keep them there for as long as possible. I'm not sure that is the case on this board right now, though, simply because there are not many people actually using the Tight Regulation Protocol in that way. Most people are modifying it in one way or another. And sometimes the modifications make sense, and sometimes they don't.