06/29 Monty AMPS 232 / +4 164 / PMPS 187

Discussion in 'Lantus / Levemir / Biosimilars' started by Tom & Monty, Jun 30, 2020.

  1. Tom & Monty

    Tom & Monty Member

    Joined:
    Mar 4, 2020
    This AMPS (06/30) is 155, going to inject 0.25IU and test at +4.

    Trying to find a stable dose, started mid day testing yesterday for pre shoot numbers that look likely to take him lower.

    History: a near hypo two weeks ago dropped his dose from 2.5 to 1.25 (ketones negative). Far too many pre shoot numbers were skips or tokens, he's now on 0.5. Trying to lower until I get a dose stable enough that it's consistent and I can get a curve.

    His current pattern is that his pre shoot numbers drop lower and lower every injection and every 3rd day he needs a skip or a token.
     
    Si am cat mom likes this.
  2. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Tom, I would not have reduced the dose down to 0.25u, Monty hasn’t even had a green BG on the 0.25u.
    Have you chosen a dosing method to follow yet?
    At the moment you are just guessing with the dosing without any real knowledge
    If you follow a dosing method you will at least be following a proven method.

    Also yesterday when you got a +4 of 164 following a AMPS of 235, I would have tested again to see how low the dose was going to take Monty.
    Without more mid cycle test in both the am and pm cycles or a before bed test in the pm cycle, you are not going to get far because you are just stabbing in the dark at the moment. The correct way to increase or decrease Lantus is by doing it based on the nadir which is the lowest BG the cycles.

    We are happy to help you.
     
    Tom & Monty likes this.
  3. Tom & Monty

    Tom & Monty Member

    Joined:
    Mar 4, 2020
    I'm attempting to follow SLGS while I get better at testings (without help from my partner). His AMPS this morning of 155 means a token dose according to the sticky on dosing methods, I'm unable to measure below 0.25 on my syringes with half unit markings so I opted for a half dose with monitoring at least at +4 today.

    My ability to test at the moment is dictated by my partners schedule which is why I'm going to start practising solo testing.
     
  4. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Probably good choice to follow SLGS method while you get better at testing and learn about FD. You will find the method at the top of the Lantus In a yellow sticky.
    Basically you hold the dose for 7 days then do a curve to see if you need to increase the dose. If you drop under 90 you decrease the dose.
    If you can post each day we can help you day by day and answer questions. Read other posts if you can to gain insight into FD.
    If you get a Preshot you think is too low.... stall, don’t feed any food and retest in 20 minutes to see if the BG is going up. Also post and ask for help. Change the subject line and say something like... stalling, BG xx, need help.
     
    Tom & Monty likes this.
  5. Tom & Monty

    Tom & Monty Member

    Joined:
    Mar 4, 2020
    Do you have any experienice or know of videos demonstrating solo testing on a cat that won't voluntarily stay with me while I do it.

    I adopted him at 11 and he has the habits he has. He won't ever sit on my lap and I need help testing currently as my partner needs to hold him. He doesn't struggle as we give him chicken throughout the poking but he'd clearly rather be somewhere else and would be if he wasn't behind held.
     
  6. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    I don’t know of any videos where the cat is difficult.
    I used to put Sheba between my knees as I was kneeling on my heels. If I leant forward I could hold her around the chest with one hand so she couldn’t move forward and she couldn’t move back as I was there. She wasn’t restrained but she couldn’t really move either. I used to get everything ready before I got her and the strip into the meter. I knew how long I had before the meter timed out. Time how long you have on your meter before it timed out. I put her snack down and as she started to eat I pricked her ear and held the strip on the spot of blood. If you need to warm the ear first try and do that before you get in position so he doesn’t feel like he is being held too long.
     
  7. Tom & Monty

    Tom & Monty Member

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    Mar 4, 2020
    Thanks, do you know how long the ear stays warm after being heated? If I give him a piece of chicken it distracts him for maybe 5 seconds - is that enough time?
     
  8. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    The ear should stay warm long enough for you to get the blood. Be organised with everything first. Cut the chicken up into small pieces so it takes longer to eat. If you cook the chicken keep the juice it’s cooked in to give him as well. I used to give Sheba chicken stock I had cooked myself ( with no salt or anything but chicken added. ) That takes a minute to lap up and will keep his mouth in the trough!
     
  9. Tom & Monty

    Tom & Monty Member

    Joined:
    Mar 4, 2020
    Thanks, we went for an ear test today, heated his ear with a hot water bottle and got plenty of blood. I did puncture his ear as I saw blood on both sides but I don't think that's so much of an issue?

    I also burned through 6 strips today because I had trouble getting a +4. I've run out of strips and my new bottle is a day late. Will it matter if I use my old glucometer (CentriVet) for his AMPS which is a feline glucometer, will the numbers be valid when compared with AlphaTrak? I think probably yes.
     
    pomflora likes this.
  10. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Yes you can use a different meter. Just note it on the SS and be aware there might be a bit of variance.
    Congrats on getting the blood! Well done!
    make sure you hold the spot for a minute to stop bruising.
     
    pomflora likes this.

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