Newbie - Marco - 3/20/20 - AMPS = 288; Dosing questions

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by Mnm, Mar 20, 2020.

  1. Mnm

    Mnm Member

    Joined:
    Mar 17, 2020
    Hi-

    I am new to this. Marco had his first set of "reliable/consistent" numbers last night. He finally got down into the BG=145 stage. (Only ever time this happened was a few weeks ago on a barf after eating - don't have data logged).

    I had him at 1.5 units of Lantus. I chickened out and only gave him 1.25 units this morning. I don't know how bad that is to change the dose like that. He was really going down rapidly (compared with anything I've seen on him) from 3/19 AM to 3/19 PM on the 1.5 units of Lantus, so I opted for the 1.25 units of Lantus 3/20 AM.

    Again, is it bad to change the quickly? I'm scare of him going to low. At the same time, I just don't know how this works. I would love some input.

    Thank you-

    Wendy and Marco
     
  2. Mnm

    Mnm Member

    Joined:
    Mar 17, 2020
    Apologies. I forgot to put date in title. Not sure how to edit the title. This is a posting on 3/20.
     
  3. Astexcat

    Astexcat Member

    Joined:
    Dec 4, 2019
    At the top of your post on the upper right hand side should be an edit button, click on it and it says edit title
     
  4. Mnm

    Mnm Member

    Joined:
    Mar 17, 2020
    Thank you!

    I don't understand his numbers. Yes, I gave 0.25 less in units this morning, and his numbers just go up up up instead of down. He was at 288 when I gave him insulin, now he's at 366.
     
  5. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Hi Wendy,
    When you are using Lantus, it is important to stay with the same dose unless Marco has earned a reduction (drops under 50) or needs an increase in dose. Lantus is a depot insulin which means that part of the dose is kept in the body for future use and that depot needs to fill and stay stable. If you chop and change the dose you will get wonky numbers. So you need to choose a dose and stay with it for at least 6 cycles (3 days) unless he drops under 50 (TR) or 90 (SLGS) ....more about that below.
    Here is a link to read about the depot
    http://www.felinediabetes.com/FDMB/threads/what-is-the-insulin-depot.150/

    Moving forward, you need to chose a dosing methods that suits you. There are 2 dosing methods....SLGS ( start low go slow) and TR (tight regulation).
    With SLGS you hold the dose for 7 days, do a curve and increase if needed. Reductions in dose are taken if Marco drops under 90.
    With TR you increase every 3 days if needed and reduce when dropping under 50.
    Please read this link and choose which one you want to follow. If you could add that to your signature that would be great. Thanks
    http://www.felinediabetes.com/FDMB/...-low-go-slow-slgs-tight-regulation-tr.210110/

    Do you have plenty of higher carb food and honey or Karo if you need it if Marco drops low? When you buy them, mark the number of carbs on the top of the cans with a marker and put in a different spot to your normal food.
    Here is a link to hypos and managing them
    http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

    Also how to manage low numbers. If you are testing remember you are in control. Feeding some food will help bring the numbers back up.
    http://www.felinediabetes.com/FDMB/threads/dont-panic-or-how-to-handle-low-numbers.210109/

    Marco is bouncing from the blue numbers he had in the pm cycle. Marco has got used to being in high numbers now and his body thinks that they are now the normal numbers. When he drops into lower numbers that are heading towards normal cat numbers his body thinks he is dropping too low and he says help, save me, and his body dumps regulatory hormones and stored glucose into his system and his BG shoots up high.
    Bounces can happen if a cat drops too fast, too low or drops into numbers he's not used to.
    Bounces can last for up to 6 cycles. There is nothing you can do but wait them out. Many new FD cats do this ...it is normal.
    Marco has to get used to being in normal numbers again. It will take time. The more he is in better numbers the faster he will get used to them.
    Bron
     
  6. Mnm

    Mnm Member

    Joined:
    Mar 17, 2020
    Hi Bron-

    Thank you very much for your reply, all of your words, information, and explanations. It's hard to know what to do when you don't have enough education on this. It's overwhelming. You get sent home with insulin and syringes and are told to monitor. It gets scary when things start to change and you don't know why, much less what the correct decisions are.

    Your words and information helps a lot.

    Yes, I have karo, honey, and I will get some high carb foods.

    Thank you very much! I really appreciate it.

    -Wendy and Marco
     
  7. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Very happy to help. We all understand how hard and confusing it is in the beginning. So keep asking lots of questions. If you are unsure of something, post and ask for help. Change your subject line to reflect your needs.
    This is a very supportive and kind community and we are dedicated to helping Carers and their kitties.
    Have a read through the 2 dosing methods and choose one and then it is much easier as you are following a plan.

    It will get much easier I promise and it will just be a routine thing..... I know.. hard to believe at the Moment!
    Bron
     
  8. Mnm

    Mnm Member

    Joined:
    Mar 17, 2020
    Thank you!!!
     
    Bron and Sheba (GA) likes this.
  9. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    Welcome to the group!

    One suggestion is to take a look at the sticky notes at the top of the board. In particular, the sticky on dosing methods.

    Lantus dosing is based on the lowest number in the cycle -- the nadir -- and not on the pre-shot number. Because Lantus is a depot-type of insulin, it's recommended that you hold the dose for at least 3 days to a week. Depending on the dosing method you choose, it dictates when you reduce the dose and how long you hold a dose for. With Tight Regulation (TR), you reduce when numbers drop below 50 and hold the dose for 3 days (there are some additional nuances here). With Start Low Go Slow (SLGS), 90 is the point at which you reduce and doses are held for a week. When holding the dose with either method, you do so unless a reduction is warranted.

    While dosing is based on the nadir, it's important to always get a pre-shot test. It's the only way to be certain that it's safe to shoot.

    The learning curve is steep and it's absolutely normal to feel overwhelmed. Like Bron noted, much of managing your cat's diabetes will become a part of your routine. And, of course, we're always here to answer questions.
     
  10. Mnm

    Mnm Member

    Joined:
    Mar 17, 2020
    Thank you Sienne! I am diligently reading. My first hope is to do Tight Regulation. I am also reading Start Low Go Slow.

    Thank you for the info (I didn't catch it before) on dosing based on the lowest number in the cycle. It's hard to see Marco's nadir at this point as his numbers are still all over the map.

    His numbers were so wild for a while, then all the sudden stuff started happening with low numbers (comparatively speaking), and I really go caught off guard.

    Thank you to everyone! I appreciate all the input so much!

    -Wendy and Marco
     
  11. Noah & me (GA)

    Noah & me (GA) Well-Known Member

    Joined:
    Dec 3, 2016
    Our Marco says hi and welcome.
    marco_001.JPG Street-smart, goes for short walks. Loves being in the car!
     
  12. Mnm

    Mnm Member

    Joined:
    Mar 17, 2020
    Hi to your Marco and all from Wendy and Marco!

    Love the short walks and car!

    I love walks, Marco is not into walks or car rides. Marco does like to play "mouse baseball". I toss a toy mouse, he bats it, and I "field the shot and pitch once again."

    Thank you for the warm welcome. It's so comforting to be a part of this group and to know there are so many others like us.

    I love your words, "be the person your cat thinks you are". Wow, powerful and true.
     
    Noah & me (GA) likes this.
  13. Ti-Mousse

    Ti-Mousse Well-Known Member

    Joined:
    Dec 2, 2018
    Welcome with us Wendy! There's a lot of things at the beginning but don't worry, everything will get easier soon!

    In case no one mentioned it, we create a new condo (thread) each day or whenever you need it. It's easier to read instead of having to go through a very long post and we can backtrack your history!

    Here is how to "link" your previous condo.
    1. Call up your previous condo and go to the very top line of your browser's screen, where you will see the URL for the condo (www. felinediabetes.com etc. etc). Highlight this URL (right click on a PC; control click on a Mac). Click the "Edit" button and click "copy" (on some browsers, "copy" will automatically appear, so you don't have to click the Edit button).
    2. In your today's condo write at the top of your post something like "Previous Condo", or "Yesterday". Highlight the word(s) you just wrote.
    3. Go to the function bar at the top of the Lantus Forum and click on the symbol that looks like a chain link (7th symbol from the left). A dropdown box will appear asking for the URL. Go back up to "Edit" on your browser and click "paste". The URL will appear in the box.
    4. Click on "insert".

    Now let's see what Marco will do on that dose!! :)
     

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