? 8/13 Nelson amps 194, +5 142, +7 74, +8 63, pmps 103, +1 103

Discussion in 'Lantus / Levemir / Biosimilars' started by Nelson and Taz, Aug 13, 2020.

  1. Nelson and Taz

    Nelson and Taz Member

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    Hi wonderful people. I haven't posted for a little while. Nelson is doing really well. I'm tempted to hold at 4 units. I'm not sure if this is for him or my anxiety of a hypo lol. Would love your opinion. Thanks
     
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  2. tiffmaxee

    tiffmaxee Well-Known Member

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    You are seeing some nice runs. I’d hold for now to see if it continues. I’m sure others will chime in.
     
  3. Nelson and Taz

    Nelson and Taz Member

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    He's up to 4mmol now at the half hour mark. So happy right now. Yippee
     
  4. Briere Fur Mom

    Briere Fur Mom Well-Known Member

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    Beautiful cycles starting to unfold with Nelson. He's clearing bounces more quickly. Starting to stay at the beach and lagoon for longer periods of time. Very nice improvement. Since you're following TR I have a feeling you'll be shooting greens soon. Since you test so much:kiss: you have time to intervene with low #s. I'm a big fan of +2 testing. That test can reveal what type of plans Nelson has for the cycle. Can help you slow down significant drops that result in bouncing.

    Since Nelson is newly diagnosed you hold this dose until he hits a # below 50 on a human meter. The reduction amount would be by .25u. This dose is really agreeing with him for now. And just remember....you're in control of the cycle. Testing, food propping with MC/HC food or even Karo can become necessary. But you're in control.
    Most cats show no symptoms when they hit some lower #s. Hypo is much different than low #s. Hypo is the physical symptoms. Through testing, food propping and monitoring we stop them before they reach that point. My civvies often test in the 40s(yes I test my civvies). My OTJ boy tests in the 40s from time to time, but he likes the 50s. I'm not telling you to get complacent. ECID. Just trying to reassure you that green #s are what we strive for! And flat green cycles are what my Lantus dreams are made of:D:D:D;):bighug:
     
  5. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    I just want to clarify that while it’s normal for a cat not on insulin or a cat off insulin to test in the 40s, we don’t want our kitties on insulin to be in the 40s. If a cat drops under 50 on a human meter or 68 on a pet meter, you need to bring them up over 50 with some higher carb food or if needed honey or Karo.
     
  6. Nelson and Taz

    Nelson and Taz Member

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    Thanks guys, that's awesome. I've shot an 88 before but that was when he was really bouncy. He's not so much anymore. Just recorded a 70 now with 2 hours till pm shot. Not usually anyone on the board then. Any advice for pm shot time pls?
     
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  7. Briere Fur Mom

    Briere Fur Mom Well-Known Member

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    Thank you for clarifying that Bron. That could've been confusing:banghead: We absolutely don't want our insulin dependent kittys hanging out in the 40s. We stop that before it happens and bring them up with carbs if it does happens.
     
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  8. Briere Fur Mom

    Briere Fur Mom Well-Known Member

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    2 hours is well beyond my bedtime:( @Bron and Sheba (GA) are you going to be around for support?

    Hopefully in 2 hours Nelson #s will have come up some making it a bit more comfortable to shoot.
     
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  9. Briere Fur Mom

    Briere Fur Mom Well-Known Member

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    It's hard for me to say what to expect for the coming cycle. His cycle has changes a lil bit. Nelson's starting to break bounces quicker and getting some duration from the insulin. If he's going to continue his "trend" then I would expect to see blues/greens tonight. This could make for an exciting cycle, especially shooting a green.
    If it were me and I was presented with a much lower than normal PS, you can refer to the TR guidelines regarding how to handle lower than normal PS #s (stalling etc). Being that it's a night cycle, your 2nd green PS, and there may be no one around to lend support, I may be inclined to give a reduced dose. That's not something I like to say. Especially since Nelson is really starting to see some good #s recently. Do read over the options you have in this link on how to handle lower than normal PS #s.
     
  10. thebigfuzz

    thebigfuzz Well-Known Member

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    Hi! I just got home from work and will be up for a while. @tiffmaxee is west coast too. I can offer the moral support if @tiffmaxee can offer dosing advice :bighug:
     
  11. tiffmaxee

    tiffmaxee Well-Known Member

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    When do you shoot?
     
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  12. thebigfuzz

    thebigfuzz Well-Known Member

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    Sounds like in a little over an hour now.
     
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  13. Nelson and Taz

    Nelson and Taz Member

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    Thanks so much guys. Yes just over 1 hour from now. He had a snack about an hour and a half ago so his next bg will be his pre shot. So reassuring to have someone here for us. This is so great for Nelson after 3 months. I don't want to miss tonight's dose either.
     
  14. tiffmaxee

    tiffmaxee Well-Known Member

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    See you in an hour. We try to stop feeding 2 hours before preshot so it’s not food influenced. Perfect
     
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  15. thebigfuzz

    thebigfuzz Well-Known Member

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    See you in an hour! :)
     
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  16. Nelson and Taz

    Nelson and Taz Member

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    Hey there again lovely people. Nelson has a pmps of 103. How shall I proceed?
     
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  17. thebigfuzz

    thebigfuzz Well-Known Member

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    Oh hello! Well, I am glad Nelson started to come up a bit at PMPS :) going to tag @tiffmaxee for some dosing advice.
     
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  18. Nelson and Taz

    Nelson and Taz Member

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    Thank you. He ate all his dinner
     
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  19. thebigfuzz

    thebigfuzz Well-Known Member

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    Just outside of the greens, which it sounds like you have shot before (when Nelson was bouncy, as you say).

    Have you fed already?
     
  20. Nelson and Taz

    Nelson and Taz Member

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    On the 30th July I shot an 88 but he was still bouncy so it didn't frighten me as much as now.
     
  21. thebigfuzz

    thebigfuzz Well-Known Member

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    Let's remember that I am the moral support delegate of the evening LOL.

    Ultimately, it is up to you. I am curious your thoughts.

    From what I see is the PMPS is higher than your last test, so it looks like the insulin is waning and Nelson is on the way up. It's important to remember that we are shooting the nadir, not the preshot. You have a few options...reduce or shoot and monitor. If you aren't sure what will happen, reducing may be an option? I am hoping tiffmaxee will arrive for the dosing official advice :bighug:
     
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  22. tiffmaxee

    tiffmaxee Well-Known Member

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    You have shot blue before. The thing is I can’t stay with you.
     
  23. Nelson and Taz

    Nelson and Taz Member

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    Yes I'm a little unsure and thank you for the moral support
    I'm ok to test through the night.
    I'm going to go for the 4 units. Can I just get a confirmation on that @tiffmaxee
     
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  24. tiffmaxee

    tiffmaxee Well-Known Member

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  25. tiffmaxee

    tiffmaxee Well-Known Member

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    As long as you can stay up it’s safe to shoot. I’d get a +1 and +2. I’m hoping Bron can check on you.
     
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  26. thebigfuzz

    thebigfuzz Well-Known Member

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    I need to test Cosmo at midnight so I'll be up till then at least. Team UK usually gets up at midnight ish..
     
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  27. Nelson and Taz

    Nelson and Taz Member

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    Thank you. I have given his usual 4 units.
    When he was on the libre monitor for the first month he would read LO and go up to 20 mmol. He responded well to the high carb biscuits and didn't show clinical signs. The most wonderful thing is he's feeling better because he's sleeping with me again and that makes it easier to monitor over night.
     
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  28. thebigfuzz

    thebigfuzz Well-Known Member

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    Ok, let me know if you need anything. Your moral support is here. Hoping for a nice green, safe cycle :bighug:

    Cosmo is at 3 units now, and I know the 'higher' units can seem daunting :confused: We don't have nice numbers like yours yet.
     
  29. thebigfuzz

    thebigfuzz Well-Known Member

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    When do you normally feed him?
     
  30. tiffmaxee

    tiffmaxee Well-Known Member

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    We shoot low to stay low. I’d feed a little each hour. Don’t feed too much at one time so you keep him hungry. If his test at +2 is the same or lower than the preshot you need to test again in an hour. If he has a good food bump you can test in two hours. If he gets to the 60’s I would feed some mc.
     
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  31. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Hi Taz I can be around for the next several hours if needed. I’ll check in at +1. Can you keep the SS updated please?
    Can you confirm the +1 will be in45 minutes at 5 pm our time.
     
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  32. tiffmaxee

    tiffmaxee Well-Known Member

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    Thanks Bron.
     
  33. thebigfuzz

    thebigfuzz Well-Known Member

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    Aww. We have 2 boys and neither are night time cuddlers. Cosmo can't get up on the bed anymore (arthritis + neuropathy).
     
  34. Nelson and Taz

    Nelson and Taz Member

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    Overwhelmed wit
    Aww, sorry to hear that. Its all about the cuddles however you can get them
     
  35. thebigfuzz

    thebigfuzz Well-Known Member

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    @Bron and Sheba (GA) looks like +1 is in about 15-20 mins :)

    @Nelson and Taz it's ok..I love to sleep and sometimes they can hog the bed LOL. Cosmo used to sleep beside me for the first 20 mins to tuck me in. Haha. Our civvie Jasper likes to tuck us in, but then they have nighttime 'business' to take care of LOL.
     
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  36. Nelson and Taz

    Nelson and Taz Member

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    @Bron and sheba +1 is 5.7mmol same as his preshot. Think I might be in for a long night.
     
  37. thebigfuzz

    thebigfuzz Well-Known Member

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    Did you happen to feed a little @Nelson and Taz?

     
  38. Nelson and Taz

    Nelson and Taz Member

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    He had a big dinner.
     
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  39. thebigfuzz

    thebigfuzz Well-Known Member

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    Ahh, yes. Was just thinking of what @tiffmaxee had suggested :)
     
  40. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    I would give a small snack now Taz. Just a couple of teaspoons of normal low carb.
     
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  41. Nelson and Taz

    Nelson and Taz Member

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    I think he's too full from dinner yet to give anymore food. Thinking I might need him to eat later when really needed. I understand where you are coming from though. Just feel I need him to have room for food for a bit later. Does that seem logical for the moment? Thank you
     
  42. thebigfuzz

    thebigfuzz Well-Known Member

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    You do want him to be hungry later when/if he needs it. I think that is why @Bron and Sheba (GA) suggests just a tsp or two of regular LC so he may be hungry later. I'm not sure how your guy eats and appetite in general though.

    The good news about food is that protein takes longer to digest and metabolize than carbs - which hopefully will allow the pm meal to kick in when you want it to. The extra little bit of LC at +1, +2 is intended to prop things up just a bit, I think. (in case it's a pretty active cycle)

    The +2 will tell you more about where things may go through the pm cycle. I think you are about 30 mins away from +2?
     
  43. thebigfuzz

    thebigfuzz Well-Known Member

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    Just checking in on your +2 :) How did it go?
     
  44. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    I see the +2 is 99 on the SS so holding much the same. can you see if he’ll have a small snack now please?
     
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  45. Nelson and Taz

    Nelson and Taz Member

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    Ok sorry just did a bg and it was 4mmol. So he's had a few bikkies. Didn't let him have as many as he wanted. Just enough to hopefully ride the green.
     
  46. thebigfuzz

    thebigfuzz Well-Known Member

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    I hope you guys ride the green safely through the night :cat:

    If it's ok with you, I need head to bed. I think @Bron and Sheba (GA) said they could stay for a while longer and looks like team UK is waking up. Do you think you are OK? I'm not sure if you are planning a +3?
     
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  47. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    4 mmol is 72 in US numbers. That is quite a drop. You have The 72 in the +3 column. That’s not correct. We are only up to 2 hours 20 mins max after shot.
    Do you have any wet high carb food?
    Please test again in 30 minutes. We will be watching.
     
  48. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Thanks @thebigfuzz yes go to bed. It’s only 6.20 pm here
     
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  49. Nelson and Taz

    Nelson and Taz Member

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    Thank you @thebigfuzz for the support. Sleep well. Love the pic of your fur baby, absolutely gorgeous. I'll be checking every hour through the night til I feel comfortable he's in the clear. Xo
     
  50. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Taz, I need you to test again in 30 mins from the last test. Please indicate you have seen this post
     
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  51. thebigfuzz

    thebigfuzz Well-Known Member

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    Ok, goodnight. Surf safely!
     
  52. Nelson and Taz

    Nelson and Taz Member

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    He usually has his shot at 3.30. Tonight it was closer to 4. Think I'm lost with time and just round up or down. Sorry if I've confused things.
     
  53. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    So +1 was 5 pm, +2 was 6 pm and the 72 looked like it was +2.25 so you need to take the next one at 1/4 to 7 pm which will be +2.75.
     
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  54. Nelson and Taz

    Nelson and Taz Member

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    Hey Bron, just got a 3.3 mmol. That is a +3, I changed the ss. He had his shot at around 3.50pm. I just let him have some more bikkies too. I think he'll be fine as long as I keep checking and leaving enough room for more food. How's that sound to you?
     
  55. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    It’s very early in the cycle. I think you should give him a drop of honey. I’d like him a bit higher at this point. The bikkies aren’t doing anything. What are they?
     
  56. Nelson and Taz

    Nelson and Taz Member

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    I really think he's fine. He was this low this arvo and came back up without food. I was told honey is for when they can't eat and are in a coma. He's still got room for food. I have tried to give him honey in the first week of his dx and he f* ing hated it. I risk traumatising him. They are purina ff tuna prawn makerel and crab bikkies. I can give him more. He's very food driven.
     
  57. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    How many carbs are in the bikkies?
     
  58. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Taz, getting 56 at +3 is very different to getting to getting 63 at @8.
    At +3 the insulin is just starting its action and at +8 the insulin is starting to wear off.
    At +3 you need to have a bit of lee way for when the insulin is working at its hardest. At 3.3 or 59 you don’t have much of a leeway if things start to drop.
    I don’t know who told you honey was only for when they are in a coma and when they won’t eat but they are not correct.
    Honey can be given when you need to bring the BG up higher when the high carb food isn’t working.
    Bikkies are not a good option for the hypo box. If you look at our hypo box it has canned high carb food in the hypo box.
    I can only tell you what I would do if Nelson was my cat.
     
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  59. Nelson and Taz

    Nelson and Taz Member

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    Well the 2nd ingredients are maize, wheat etc in the ff. There's also some senior consultant stage 2 from the vet and the 1st ingredient is wheat etc before any protein. I've mixed them together .
    I do understand where your coming from. It does seem to early for such a low number. But I did agree to shoot low. I'll keep feeding and monitoring his bg during the night.
     
  60. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    That’s good you shot low. But when you first do it it is always better to err on the side of caution until you have the data to support how he will react to shooting low.
     
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  61. Nelson and Taz

    Nelson and Taz Member

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    This is so stressful. Vet told me honey was for coma. Nelson told me honey was for coma. This board told me to shoot and my vet probably would have too. Anyway he's still at 3.3 just now and just had some of the vet bikkies. I'll check cupboard for hc wet food. Sorry for slow replies, I have a high needs person in the house at moment.
     
  62. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    That’s OK, please post your next BG. I’ll be watching :)
     
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  63. Nelson and Taz

    Nelson and Taz Member

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    What if I put some honey in some wet food? I wonder if he'll go for that? Can only try I guess. Yes I'll post next bg. Thanks for the support.
     
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  64. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    See what the next BG is first before deciding about the honey. A drop of honey mixed with low carb food will make it high carb. Don’t leave it an hour though before testing again. We want to catch any drop before it drops too far.
     
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  65. Nelson and Taz

    Nelson and Taz Member

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    Still 3.3. Will try the honey.
     
  66. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    If he’s staying at 3.3 he is doing well. You could leave the honey and just give low carb and see what he is next time
     
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  67. Nelson and Taz

    Nelson and Taz Member

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    I already gave some honey in wet food and I've left some wet food out. Things are getting tricky here so I'll do a 911 if things get bad. I don't expect you to stay up and I love my boy so I'll check thru the night. Thank you to everyone that helped today.
     
  68. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    I’ll not be going to bed for another 2 hours.
    Just post the BGs on the SS if you can’t keep posting. I can see them there and I’ll post if I need to.
     
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  69. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Taz honey only lasts an hour or an hour and a half before the effect wears off so you need to be aware of that so you will need to keep testing.
     
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  70. Nelson and Taz

    Nelson and Taz Member

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    Thanks. Can you tell me what kind of reduced dose I can give at 3.30 in the morning? Can't go through this again. Do I just go down to 3.75? Or less?
     
  71. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Without knowing what he’s going to be at at AMPS I can’t really say. You can post and ask for advice. There should be plenty of people online at that time of day from the US.
    He hasn’t really earned a reduction but it’s really up to you. If you feel you need to reduce the dose you could go down to 3.75 units, providing he is high enough to shoot, but be aware that the depot from the 4 units will still influence the BGs for a few cycles after you take a reduction.
    He is just starting to give you some lovely green numbers on the 4 units.
     
    Last edited: Aug 14, 2020
  72. tiffmaxee

    tiffmaxee Well-Known Member

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    Those were beautiful numbers on the last cycle. It’s scary shooting low the first few times but Bron helped you keep him safe. Thanks to Bron for stepping in.
     
    Last edited: Aug 14, 2020
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