Bubba- Need help - pm shot in 10 min

Hi Everyone

Quick recap = Bubbas third shot of Lantus- (Humulin before )
Yesterday at pm shot 1u lantus
AM shot we started him at 2 u
amps 401 +6 290 +9 279 +12 256

Shot due at 282 at 7pm here. Go for 2?

Ok, Bubba is use to getting up at 530 am to eat- He will rip the house apart if we dont.
So with N, I was holding off and testing at 6am and then eat in order to have enough time to get food in him
by 7am

Just now out of habit I gave him a 1/2 of FF and said OMG picked him up and tested him right away
to see where his numbers were since he should have not eaten until 7pm ( shot due)
He was at 256. Maybe 5 mins after the food.

Since Lantus is longer acting and not out of his system, and now I fed a little I am nervous.
If his shot is at 7pm , how far in advance am I allowed to test? I dont know how to fix his schedule of eating?
He normally gets a few small meals throughout the day.

Its only the second day and not sure how much if any of the lantus has been stored yet,
Dont want a Hypo situation on my hands this early in the game. He moved a great deal today from am shot to +6
( His numbers were not really moving any longer on N)

Will a hr be enough to have a semi accurate test result at 7?

Also, I know I missed a few tests today
but does 2 u look ok for him so far based on his numbers? I am in a panic thinking is 2 tonight going to pull him down a lot?

So confused, so sorry.

Can you post a number at 7 before shooting?
Carl

Hi Carl.

He was at 282 ( and I am sure there is a food spike there) and also some Prednisolone spike.
I called my vet and he Backed him down to 1u tonight.
He said those numbers are including Pred and you do not want him to drop??

I am so confused, and cant seem to get this right w Lantus

I am messing this up big time. I am not being consistant at all!
Bubba has so much thrown into the mix here. I think he may be cautious with the additional asthma treatment
and may want to stay in the 200? I dont know but I feel so defeated with all of this.
I was flying high today that he finally dropped!

Jackie

Deep, slow breaths. Everything is fine! Let me look at his SS. One thing that will help us is if you talk in terms of hours from his last shot because we are all on different time zones. So let me see if you have it armed on the SS and I'll be right back.

Thanks Marje I'm @ work.

Jackie, Marje is right. Deep breaths You're doing fine. It's a lot to juggle but it gets easier, I promise.
Carl

Ok...yes, it's best if he has two hours before his shot that he doesn't get fed but if he's eating LC and he's in the mid 200s, then you are ok to shoot 2u tonight. He's been pretty flat since +6.

I would not decrease his dose to 1u tonight, Jackie. Keep in mind that you are testing and "if" he does come down some, you can control his curve with food. Your vet probably wanted you to drop his dose because he (your vet) is not that familiar with lantus nor does he want to worry.

But we can help you if he comes down...he's pretty high right now and remember that it does take a few cycles for lantus to fill the depot, typically. Of course, since he's a cat, there are no guarantees but you need the consistency and a number in the mid 300s is fine to shoot the 2u.

Please post once you shoot and we can help you on the next tests to get. Everything is ok

Thanks Guys. I am sorry but I think my vet is conservative and I keep thinking about his shed and how I am being all over the place with his dose. It cant be normal. He had a asthma attack today and had to get more Pred at noon.
I just feel like a dummy and dont want to hurt Bubba. I have the vet saying one thing, my head saying something else
I just feel lost.

It's really ok....I can see how you would feel stressed and anxious. Just think about Libby and Sienne's input yesterday. They are very experienced and wouldn't have suggested the increase if they didn't think it was safe. Also remember that we discussed a couple weeks ago how much better it would be for him to be on a basal insulin like lantus with a bonus when he needs it.

The pred will keep his numbers up, most likely, until you start decreasing it. But all you have to do is post here if you get a number that worries you and we will help you through it.

I just feel like crying, really! I didnt have any posts and I was so scared to go past 7 pm for his shot so I gave him like 1.25 ( he said 1)
I thought of food uping and that was me being brave with the .25

I went with the vet only because I am so new to this and I trust you guys, a lot actually but I needed to do something.
I cant keep going back and fourth here, I am going to really hurt Bubbas chances I feel.
I think he is going the conservative route here. I was so very happy that Bubba was in the 200's today I swaer I could have put a party hat on him. Not remission but they were just about to test him for being insulant resistant.

He did have some nice movement today right?
I am sorry I had to make a move and had vet instructions. I feel so super upset really!
I am just beside myself. I pray I dont continue to mess this up!

(((Jackie))))

Please don't be so hard on yourself. This journey is difficult starting out even when kitty is not sick and you've been dealing with alot. As last night, just consider this a partial fur shot and you can start back with 2u tomorrow morning.

Also...it's ok to be a little late on a shot. Shooting late acts as a reduction so even if you shot a little late and shot 2u, it would have been fine. And what you did is fine, too. You aren't used to the action of lantus yet and so I understand your trepidation. But give yourself a pat on the back for all you have done and ARE doing for Bubba. You'll get it! :YMHUG: :YMHUG:

Thanks Majre and Carl !

I know I am being out of control here , but when it comes to Bubba and his history I just loose all focus
and become well, crazy. I think this is pretty confusing and throwing in the asthma attack today and the added food
my head was spinning. My vet is a angel really and I think he is going old school on me thinking Bubba is probably more in the 200 range with the food and pred tonight. I text my vet at all hrs of the day, this morning at 6am!
Tell me he isnt a saint!

I just need a dose that may not be exact, slightly conservative yet something I wont be afraid to shoot.
I think it needs to be the same over the next few days when I am home ( based on his numbers )
He told me to text him in the am with Bubbas # am reading.

He is a saint but my vet had me doing the same thing when we started out and then I quickly realized she didn't know nearly as much about lantus and FD as the folks here.

Keep in mind that many vets will not advise shooting below 200 for a variety of reasons. Many of them are very conservative. My new one has had to get used to the numbers I shoot and will run Gracie at but she has because I test.

Just to add to what Marje said and this is the biggest difference between Lantus and N -- Lantus dosing is based on the nadir, not on your pre-shot numbers. You don't keep adjusting dose based on your pre-shot test. I know you've caught on to being consistent but if your vet is going to suggest a dose based on the pre-shot, you're never going to be at a consistent dose.

This is overwhelming andd we've all been in your shoes. It really does get easier.

Marje and Sienna,

You are both right I know. I do feel he is basing the shot and dose by the pre shot. And by that I will not have a shot of getting Bubba where I need him to go with TR. I will be spinning my wheels really.
Truth be told as confident as I am in all of you I am not confident enough within myself yet to say No, go this way ,shoot when he says no etc. I am hoping that will come in time.

I know that Lantus is based on the Nadir and I am far from finding Bubbas yet. I know all cats are different, and you should continue to do +3
But is the nadir normally found? +6? I am sure its hard to tell but just curious if there is a range of time I should be zooming in on.

Again, thank you for sticking with us. I know I am quickly becoming the problem child here but I will get better, it will get better.

How about sharing this article with your vet. At least you'll both have the same information. This is the vet journal article describing the TR Protocol.



Each cat's nadir can be different than another cat's. The only way you find out where you're cat's nadir falls is to test. And just when you think you have it figured out, your cat will remind you that they don't read the rule book! For example, Gabby's nadir is typically at around +3 or +4. Then, there are those days when she throws a monkey wrench at me (e.g., 12/30 - 12/31).