? Just getting re-started w/the SLGS protocols, and have a Q about shooting late.

So, my schedule fluctuates ALL the time. Tomorrow night I will not be able to shoot at our regularly scheduled time.

Is it better to skip that shot altogether, or give him the next dose as soon as I am able? I realize this is not ideal, but I have no other choice at this time.

What If I gave a slightly higher dose in the am, to try to hold him over for a couple of extra hours? Or give him a slightly lower dose late?

Not sure what to do and was looking for opinions. This will be at a minimum a weekly occurrence for us, and I don't know how I'm ever going to get this managed.

 

Hi first, I can’t see your spreadsheet without a Microsoft account. Shooting early acts like an increase and late like a decrease. Half an hour is not a problem. How off would you be?

 

I'm probably going to be more like 3+ hours late with the shot.

I don't know why no one can see the spreadsheet. Not sure what I'm doing wrong.

 

If you shoot 3 hours late your next shot would need to be no more than 11 1/2 hours later. You can also skip and shoot 18 hours later. Then the next shot would be 12 hours from that shot but not sure if that will help.

Do you have a gmail account? Did you pick to make it public?

 

hmmm...If shoot tomorrow at 3+ hours late, but I have to be back to work at 10 am on Sunday, so it would be earlier than 11.5 hours. Then work again at 8:30 on Monday, so it's starting to look like my best option is to skip tomorrow night, and get back to the schedule after that.

Of course, I'll have the same issue on Thursday of next week, but I'll have to figure that one out as it comes. Thanks, sometimes it helps to just talk it out with someone else to arrive at the correct answer.

I do have a gmail account, but hardly ever use it. I created my spreadsheet in Microsoft one drive. I'll try to look into creating it in google also/instead.

 

You need to change the "permissions"

Go to the top right and click on "Share".....a new box will open

Make sure it's set to "anyone with the link can view"


If the option isn't there, go to the bottom right of that box and click on "advanced" and choose it there

 

Can you see me now?

 

I can.

 

OMG, it's a Xmas miracle- lol

 

Yes!! Good job!!

 

All my sympathy for the scheduling stuff, I got home two hours late yesterday. I shot it after discussing with people on the board, as these next days I can slowly come back to normal shooting time. But two weeks ago I thought I was going to be away from home 15 hours two days in a row, and really didn't see how I was going to deal with it. "fortunately" I fell ill and it didn't happen.

It was recommended that I not play with doses in my situation, but rather skip the shot (or maybe giving a token dose could work in some cases?)

Here's some of the discussion: http://www.felinediabetes.com/FDMB/...strategy-for-friday-not-home-for-shot.188226/

If you have flexibility with food and have an idea how that impacts his numbers, maybe you could also "carb load" his meal if you have to shoot less than 12 hours after the less.

 

Lantus is a depot-type of insulin versus other insulin, like Prozinc, which is more of an "in and out" type of insulin. I'm not sure how much that means to you at this point. What that information translates to is that Lantus doesn't work best if you have to change shot times and alter doses rapidly. Lantus likes consistency! The effect of a dose is cumulative. In addition, a late shot acts like a dose reduction and an early shot acts like a dose increase and they don't cancel each other out. If you need to shoot late, it can take several days of shot time adjustments to get back on your schedule. Even with skipping, the issue is that a skipped shot may help with your schedule but it has an effect on the depot. It the depot doesn't have a chance to stabilize, you are losing the advantage of using Lantus. All of the above applies if you change the dose based on the pre-shot number which could mean you end up changing the dose at every shot (and doses should be held a minimum of 3 days for the depot to stabilize). Giving more insulin will not have an effect on how long the insulin works. What it could do is drop your cat's numbers like a rock which sets up a dangerous situation if you're not home to monitor.

Shooting late, given the above information, is obviously less of a problem than shooting early. Shooting 3 hours early could put your cat at risk for dropping into low numbers without your being there to monitor. In addition, it looks like you are basing your dose on the pre-shot numbers. Lantus dosing is based on the nadir (lowest point in the cycle) which, if your cat is fairly typical, is somewhere around +6, give or take. It sounds like you're gone a good part of the day and can't test. It's very important to do what you can to get spot checks when you're home in the evenings, weekends, holidays, etc. Just to be repetitive, Lantus dosing is based on the nadir and not the pre-shot number.

Many vets are far more familiar with the "in and out" type of insulin and will tell you that it's OK to shoot anywhere within 2 hours of your preferred shot time. This really isn't the case with Lantus. As much as I hate to suggest this, if your schedule is as unforgiving as it sounds, you might want to talk to your vet about switching to Prozinc. It is one of the insulins that is recommended by the American Animal Hospital Assn for the treatment of feline diabetes (Lantus is the other insulin) and you can slide the dose based on pre-shot numbers. You will still need to try to get more test data so you have some idea how low the dose is taking Bumpsy and if a dose reduction is indicated. If your schedule is crazy because of the holidays and will calm down in a week or so, Lantus may be fine providing you start getting more tests. If what you've described is typical, you may want to consider Prozinc.

 

Thank you for this advise. I'm going to do some research into this info, and give it some consideration. I'll also have a conversation with our vet regarding Prozinc. Thank You!