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Nov 19:AMPS Walter 634 PMPS 397

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by zeldamay, Nov 19, 2019.

  1. zeldamay

    zeldamay Member

    Joined:
    Sep 8, 2019
  2. carfurby

    carfurby Well-Known Member

    Joined:
    Feb 19, 2012
    Yes stay at 1.75 units. Remember dosing is based on the nadir not the pre-shot numbers.
     
  3. zeldamay

    zeldamay Member

    Joined:
    Sep 8, 2019
    I know but he’s drinking a lot and is very hungry. I’m worried about him having ketoacidosis again.
     
  4. Bellasmom

    Bellasmom Well-Known Member

    Joined:
    Feb 12, 2018
    If u can try and get a little more tests in, we dont know how low hes going, try during day and nite
    Have a great day
     
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  5. Gill & George

    Gill & George Well-Known Member

    Joined:
    Oct 27, 2015
    this needs to be on your signature, if you are running out of space then try abbreviating
    for example, instead of having 'SLGS dosing and Alpha Trak 2' just write ' SLGS/AT2 DKA (date of episode)' to make it fit.

    You haven't got the evidence to support an increase, sure his numbers are high just before you give the insulin, but as we know, that Walter has a flare for the dramatic dropping from the black to the lime green and back to black in one cycle, you only have to look at 11/17 mornining cycle to see that.

    Given how he drops it is possible to imagine that yesterday 11/18, he could have done the same, he may not have, but we just do not know, anything could have happened. With the way he swings I would strongly recommend that you aim to get a couple of test midcycle, any time in the cycle, doesn't matter when, maybe start with a +3 and +6. Or a +2 +5, to help you determine what he is doing with BG, just because he is high one cycle, doesn't preclude him from going low the next.

    The other possibility is that he is in fact experiencing a run of high numbers, triggered by that fast drop into the blues and greens that his body is not used to yet. We call this a bounce.
    Bouncing can last up to 6 cycles, but some kitties do not bounce that long, and hard as it is to see those numbers it is a normal physiological reaction so we ignore them when we look at dosing, once his body stops bouncing we will see his numbers drop again, and it those numbers that tell us if a dose is too high or not.

    Counting back, if this is actually a bounce it looks like he is clearing bounces after about 2-3 cycles, but you have been changing the dose and can make number wonky and disrupt the patterns that we are used to seeing. So it makes it harder to judge.

    I would make an educated 'guess' and say that you might see him clear this bounce this morning of 11/19 or this evening 11/19, the only way you will be able to tell is by getting some tests in midcycle today in both the morning and evening cycles.

    I'm not sure what is happening on the SS as there is a numbers on the 11/19 line in the pm, but if you are in the US/, you cannot already be in your pm cycle, so I am ignoring that, unless you tell me otherwise.

    I would hold the dose at the moment. (have you shot already? I see you have a number in your amps box)

    DKA (Diabetic Ketoacidosis) is a concern and important to consider, with this in mind I have some questions?
    • Is he eating normally? getting enough calories?
    • Does he seem well in himself?

    High numbers on their own will not lead to DKA, it's a combination, a 'recipe' if you like of not enough insulin/ not enough calories and some other systemic stress or infection. With DKA in the history, a very important tool for you would be to get into the habit of monitoring for ketones regularly (every day), and noting the results of that on the SS perhaps in the comments section.
    I found it easy to check for ketones with my guy, his Litter Box (LB) habits are very predictable, he always goes for a pee half way through his breakfast, so I could easily catch him mid pee, I would use a ladle, scooch it under his bottom and then dip the ketone urine stick in the urine to get my test, he's also not shy when it comes to having a pee:rolleyes:
    You can get the ketone sticks at any human pharmacy, they are not expensive.
    (Blood Ketone meters are also available if you find the above method difficult)

    So in Summary Today

    • Hold the dose
    • Get midcycle checks
    • Check for Ketones
     
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  6. zeldamay

    zeldamay Member

    Joined:
    Sep 8, 2019
    Thank you. I have ketone strips and all seems well on that front. I held the dose (at work now so not able to check numbers during the day--will try to do it tonight at your suggested intervals). He's eating normally (always hungry) and seems like himself. The PMPS number on my line is for last night--I couldn't edit yesterday's to add that number and noticed that others were adding PMPS numbers in the morning.
     
  7. Gill & George

    Gill & George Well-Known Member

    Joined:
    Oct 27, 2015
    Great on no ketones/ do note when you get a test even if it's negative on the SS in the comments section. And good that he's got good appetite and acting normal. All good signs.
    Keep checking the ketones daily.

    Thanks for clariyfying, when you get a chance can you move it onto the correct day. thanks.

    Whatever you can that would help. If you get home an hour or two before PMPS a test then can also be helpful to help build a picture of his patterns. If you are gone all day that's fine to, just do what you can.

    I know how hard it is to see these blacks and reds. :bighug::bighug::bighug::bighug:
    I'm glad you held the dose for now.
     
  8. Sue and Luci

    Sue and Luci Well-Known Member

    Joined:
    Nov 3, 2017
    Try to be patient and allow time for the insulin to build. It's a depot drug and it takes a little while before you start to see any action - especially after he went low just a day or so ago - his body is responding by dumping a lot of sugar into his bloodstream. Try not to focus too much on those high numbers, but get in as many tests as you can before bed and when you come in from work - just to see where he might have gotten to as far as lower numbers that are not pre-shot. Pre Shot numbers are typically the highest of the day...

    Looking forward to seeing your updated SS soon :)
     
    Sonia & Leo likes this.
  9. zeldamay

    zeldamay Member

    Joined:
    Sep 8, 2019
    Hi— had to work late so shot was 1.5 hrs later than usual. Do I need to adjust morning shot? (BG tonight was at usual time—friend helped me out didn’t give shot).
     

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