? 11/07 Toby went WAY too low...

Discussion in 'Lantus / Levemir / Biosimilars' started by Kate & Toby, Nov 7, 2019.

  1. Kate & Toby

    Kate & Toby Member

    Joined:
    Aug 23, 2019
    Hi all,
    I was at work all day today so I had my dad pop in to check on and feed Toby, he was fine, very chipper keen to eat all normal. My amazing dad did a quick BG test and he was 81 so he gave him some more food and called me, I was worried he was still early in his cycle, +5, so Dad popped Toby in the car with him and took him home, tested him again an hour later and he was 29!
    Dad did a brilliant job of feeding him some high carb treats and gravy food, and he came up to 45 I've just got home and tested him again and he is 200
    He has obviously earned a dose reduction back to 1.5iu but do I shoot tonight, or does the depot need to drain a bit?
    Really scary, and cant help but feel my amazing dad probably saved Toby's life today.
    I just just add, he has been completely happy and chipper and his usual self the while day.
    Really need some direction now as 1.5iu was too little and 1.75 is too much, I struggle enough with the .25 doses on the u100 syringes. I dont know where this leaves us.
     
    Crista & Ming likes this.
  2. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Yikes! Thank you dad, wonderful job with Toby.

    I think what you decide to do tonight depends on what his preshot will be. If he is really high, you could easily shoot 1.5 units. Maybe get a +11 test and post for suggestions then. That’ll give you an idea where he might be at preshot.

    Which syringes are you using? Some are worse than others for consistency.
     
    Kate & Toby likes this.
  3. Kate & Toby

    Kate & Toby Member

    Joined:
    Aug 23, 2019
    Thanks Wendy, will do, I'm home now so can monitor him. He is a bouncy cat so my prediction would be he will be high.
    Attached a photo of the needles.
     

    Attached Files:

  4. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    I thought that might be them. In Canada BD is our main option too. Have you see the dosing ruler for use with BD ‘s. If you look at this article (from the Sticky Note on dosing), on the fifth page in, there is a section on fine dosing. It has a link to a page you can print off with dosing rulers. Some of us do dosing with calipers. I found that really helpful with two people in the house doing the shooting.

    High carbs and gravy can wear off after a couple hours, so good idea to keep testing.
     
    Sue and Luci likes this.
  5. Kate & Toby

    Kate & Toby Member

    Joined:
    Aug 23, 2019
    +11 and we are back in black, 35.4mm/l (cant update spreadsheet at the moment to give you US number)

    I will obviously get a pmps but is the general thought I should shoot 1.5?

    Thank you all on advance.
     
  6. Bellasmom

    Bellasmom Well-Known Member

    Joined:
    Feb 12, 2018
    Awesome Dad!!!
     
    Kate & Toby likes this.
  7. Kate & Toby

    Kate & Toby Member

    Joined:
    Aug 23, 2019
    I know right! Great catch, dread to think what would have happened if he wasnt willing and able to test. Cant believe Toby went so low at 1.75iu
     
    Sonia & Leo and Bellasmom like this.
  8. Bellasmom

    Bellasmom Well-Known Member

    Joined:
    Feb 12, 2018
    Congrats on reducie
     
  9. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

    Joined:
    May 18, 2016
    @Marje and Gracie is online at the moment.
     
  10. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

    Joined:
    May 18, 2016
    Did you shoot?
     
  11. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

    Joined:
    May 18, 2016
  12. Kate & Toby

    Kate & Toby Member

    Joined:
    Aug 23, 2019
    Not yet but about to in the next 10 mins
     
  13. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Hi Kate, Toby has earned a reduction with those low numbers today so reduce the dose to 1.5u. He went WAY too low today so reduction is a given despite how high he's jumped now.
     
    Kate & Toby and Red & Rover (GA) like this.
  14. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    I don’t see a dose on the spreadsheet, but hope you gave the 1.5 units. Skipping or reducing to drain the depot is something typically done if on much larger doses. Toby sure decided to bounce!
     
    Gill & George and Kate & Toby like this.
  15. Kate & Toby

    Kate & Toby Member

    Joined:
    Aug 23, 2019
    Yep I went with 1.5.

    Hes just wet himself and been sick. Maybe it's the steep jump making him feel rubbish.
     
    Gill & George likes this.
  16. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

    Joined:
    Jun 15, 2015
    Wonderful that your dad had super spider senses today as the 81 was a safe number. He truly is a hero !

    Good luck with the reduction!!
     
    Kate & Toby likes this.
  17. Kate & Toby

    Kate & Toby Member

    Joined:
    Aug 23, 2019
    Thank you, yes, he is a legend!
     
  18. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

    Joined:
    Sep 21, 2018
    What a great job your dad did Kate, how's Toby feeling now any better? Kate that face of Toby's is just to adorable
     
  19. Sue and Luci

    Sue and Luci Well-Known Member

    Joined:
    Nov 3, 2017
    Great catch on dad's part today!!! I believe Wendy mentioned calipers above - you'll love them once you get used to them - especially for splitting those doses up...I could not live without mine...I don't even look at the lines on the syringes anymore...they aren't reliable for consistency sake anyway...

    You're both doing a great job with Toby!
     
    Kate & Toby likes this.
  20. Kate & Toby

    Kate & Toby Member

    Joined:
    Aug 23, 2019
    Thanks Diane, he is absolutely fine again today, albeit BG is sky high, guess that's a big bounce from being so low. I am at work again today so I have dropped him off this morning at my mum and dads house so he can spend the day with them and they can keep a close eye on him. Good job they live close, love cats and he is happy to go in the car!! I feel blessed.
     
    Diane Tyler's Mom likes this.
  21. Kate & Toby

    Kate & Toby Member

    Joined:
    Aug 23, 2019
    Thanks Sue, I appreciate your kind words, I don't feel like I am to be honest. I feel like I cant help him properly and he must feel so rubbish with the highs and lows.
    I will look again at the calipers, that might just be the help I need, I cant believe how 1.75iu made him go HYPO and 1.5iu is too low a dose and kept him in pinks. Is there such a thing as 1.6iu?

    Thank you again for your support, I think every day that I do not know how I would manage without you all xx
     
  22. Sue and Luci

    Sue and Luci Well-Known Member

    Joined:
    Nov 3, 2017
    Please don't feel badly for helping Toby! You are really doing a wonderful job! And having your mum and dad close enough to help while you're at work!! That is beyond fabulous! It's not easy with these sugar-cats - it's really up to us - their beans to help them - with the right food and a little insulin - you'll be surprised at how well Toby can do. Please be patient with yourself...there will be highs and lows along the way and your dad is fabulous to monitor him so closely. It will get easier for all of you over time - let's see how Toby responds to the reduction before we make any decisions on which split dose might work best. In the meantime get your calipers ordered and play around with them - if you need help just ask! I sure needed help when I was first using mine :)
     
  23. Kate & Toby

    Kate & Toby Member

    Joined:
    Aug 23, 2019
    Thanks Sue.

    So I've just had a look at all the calipers and the videos, this could be really useful for me, it does appear we need a micro dose, even on prozinc Toby's dose was somewhere just below 1.75iu.

    Which calipers are recommended? The ones in the original post from 2012 are no longer available.
    Do you think these ones would be ok?
     

    Attached Files:

  24. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Hi Kate. I don't see a locking device on those calipers but it might be a different mechanism than mine. Check to see if you can lock them and if so then they are fine.
     
    Kate & Toby and Sue and Luci like this.
  25. Sue and Luci

    Sue and Luci Well-Known Member

    Joined:
    Nov 3, 2017

    I use these - see the little 'wheel' on the top? It allows you to 'lock' the number in place once you've selected it in the digital window:
    upload_2019-11-8_9-37-42.png

    Not sure if this is available in the UK but here's where I purchased: https://www.harborfreight.com/hand-...rs-micrometer/4-in-digital-caliper-63710.html

    Nice and light - perfect for what we're doing :)
     
    Kate & Toby likes this.
  26. Sandra And Buddy (GA)

    Sandra And Buddy (GA) Well-Known Member

    Joined:
    Oct 4, 2019
    Sorry to barge in, Just wanted to mention to pay attention to the jaws on which ever set you pick up. I think Harbor freight had a bad batch, the bottom jaw was a bit shorter than the top one you would have to angle it weird to get both jaws to touch the syringe, all of them they had were that way, so I ended up springing for a more expensive pair at out Lowes. But worth every penny. Just wanted you to be aware.
     
    Kate & Toby likes this.
  27. nslade001

    nslade001 Well-Known Member

    Joined:
    Nov 12, 2018
    Hi, I'm just popping in and saw this post, and want to *really* emphasize how important calipers can be, especially dosing with BD syringes (I'm in Canada). for the year that I used them, the vast majority were very, very poorly marked, which meant if I was just using the syringe lines to dose with, I would frequently be either underdosing *or* overdosing. At one point I took an average from my used syringes and figured that if I had two badly marked syringes in a day (not unusual) I could be dosing up to *0.75U* difference between one syringe and another, although by the marks I was spot-on the same. Not good.

    Calipers allow you to get a consistent dose, no matter the syringe markings.

    I would never use BD syringes without calipers; to me, they are not safe as mismarked as they often are. Too easy to cause a hypo.

    With love, Nikki
     
    Kate & Toby likes this.
  28. Kate & Toby

    Kate & Toby Member

    Joined:
    Aug 23, 2019
    Thank you Sandra and thank you Nikki, I have just ordered some and they will be here tomorrow! (I have watched the videos and also read the sticky, but I will be back with questions once I have them in my hand I am sure!!)

    I am sure I must have overdosed him yesterday as he has been on insulin up to 2.25iu and not gone hypo. I strongly believe the 1.75iu dose is the right dose for him so I am keen to get the calipers and see how we go.

    I guess some of our little guys are more sensitive than others to the very small changes, that is so shocking Nikki that you had BD syringes that were 0.75iu out of range!

    Than you all and I will report back tomorrow. xx
     
  29. nslade001

    nslade001 Well-Known Member

    Joined:
    Nov 12, 2018
    Hi, just wanted to clarify that it wasn't 0.75U on any one syringe, that is an example ie/ if I had grabbed two syringes reading off (mismarked) in either direction...one too high, one too low. I did have those in the same bag, though, so it could definitely happen that a similar variance would happen in a day. Around 0.25U mismark was actually common, and I'm pretty sure I had some that were almost 0.5U off.
    Too far for safety. I'm glad you're getting calipers :) You'll love them!
     
  30. Kate & Toby

    Kate & Toby Member

    Joined:
    Aug 23, 2019
    Bless you, I was in no way questioning your findings, just find it so bad! I guess where it's a human insulin and human syringes the 0.25 would have little to no effect.
    I'm shooting in 45 mins and I feel nervous already knowing the inaccuracies, but I've pulled back to 1.5iu after yesterday's hypo so should be OK, we will go back to 1.75iu tomorrow night when I have my new gadget. Thanks again for sharing and your support. X
     
    nslade001 likes this.
  31. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Kate, I suggest you stick with 1.5u for the moment. Tony earned the reduction with a very low BG. I'd give the lower dose a chance again. Dose needs change over time and can go up and down at times. It's possible that Toby's pancreas is contributing a wee bit more to the situation than it was so to keep him safe stick with the lower dose right now. :)
     
    Kate & Toby likes this.
  32. Kate & Toby

    Kate & Toby Member

    Joined:
    Aug 23, 2019
    Ok, will do, thanks Linda, im just super ketone worried as always. He seems perfectly normal today, he had a lovely day with my mum and dad, spoilt is the word! Thank you as always for having mine and Toby's backs x
     
  33. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    I understand how you feel Kate and I'd be worrying too but it looks like he's starting to turn a corner and coming down a bit so now it's a balancing act between the ketones and keeping him safe. You don't want him having a symptomatic hypo event either so a little reduction is in order.
    So lovely he has grandparents who love him so much and can help out. Very lucky kitty to have the doting family he has!
     
  34. Kate & Toby

    Kate & Toby Member

    Joined:
    Aug 23, 2019
    I hear you, and I shall stick to the 1.5iu. And continue to check for ketones.

    We are so very lucky yes. It was so funny I dropped Toby and my little boy off at mum and dad this morning, then I picked them both up tonight, it's like I have 2 children now!
     
    MrWorfMen's Mom likes this.

Share This Page