1/25 Pearl PMPS 87, +1 84, +2 99 +3 120

Discussion in 'Lantus / Levemir / Biosimilars' started by Margaret (and Pearl), Jan 25, 2021.

  1. Margaret (and Pearl)

    Margaret (and Pearl) Well-Known Member

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    Dec 23, 2020
    Happy Monday out there!

    Pearl has been swimming in the lagoon a little bit on 2.25U Lantus. Today she is on Cycle 9 of this dose. We are new to greens. Her lowest NADIR on this dose has been 75. I'd like some advice - am I supposed to upp this dose tomorrow morning, or keep it, given her NADIRs? Or stay on it a few days longer to see how it goes? I'm not sure if she might see a lower NADIR yet when she gets back down to the lagoon (on the beach now) - she is likely heading for the lagoon tonight.

    Hope everyone is surfing safely today, and thanks for your input!

    Link to yesterday's post: https://www.felinediabetes.com/FDMB/threads/1-24-pearl-pmps-145-1-108-2-75.242009/#post-2726463
     
    Last edited: Jan 25, 2021
  2. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    I’d hold the dose. The action of Lantus is cumulative and we usually hold the dose once in blue numbers for at least ten cycles. With green nadirs, I’d give her a bit more time to see if she can bring them down a bit more. My Gracie was a slow responder so if saw blue the first ten cycles, I had to hold even more to get her really working the dose.

    Pearl is also clearing bounces quickly.

    One favor to ask, please....can you add “TR” to your signature block right after “Lantus” please? It’s nice to have a quick reference. Thanks, Margaret. Your girl is doing better!
     
  3. Margaret (and Pearl)

    Margaret (and Pearl) Well-Known Member

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    Sounds good and thank you, I will keep holding the dose and see what more information little Pearl has to give us from this dose! I think we are heading to the lagoon again tonight, Marje. I'm excited but nervous if we go lower than 75.
     
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  4. Margaret (and Pearl)

    Margaret (and Pearl) Well-Known Member

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    Done, and thank you! I can't believe how quickly she is clearing those bounces!
     
  5. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    Thank you!

    Shes doing great with you at the helm!!
     
  6. Margaret (and Pearl)

    Margaret (and Pearl) Well-Known Member

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    Oh lord!...Marje, at +11 we are only at 121!!! She has slid down this entire cycle. No NADIR earlier in the cycle. I will test again for PMPS in 1 hour, but what in the heck do I do? If I shoot, it will be my lowest shooting yet. Eeeeek! Thanks for your advice!
     
  7. Hercule's mum

    Hercule's mum Well-Known Member

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    Jul 27, 2020
    Hercs does this constant sliding thing.... I have been told this is due to a bounce-breaking cycle. Pearl probably was bouncing this morning because of the green last night, and the declining numbers is not insulin or action (or not only) but also the "dissipation os the bounce". At least that is what I understood....

    With regard to the dosing it is nerve wracking, but they say lantus is an insulin to shoot when low to stay low. You can only do what you are confortable with, but I have been reminded many times that what you are shooting is the value in about two hours (when Lantus usually starts the onset). When I am making this decision I usually considered whether I can stay awake, or wake up to check frequently, and that I have MC and HC (or honey) if necessary, and whetehr I have enough strips.
     
  8. Margaret (and Pearl)

    Margaret (and Pearl) Well-Known Member

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    Dec 23, 2020
    THank you for this! My problem is that Pearl doesn't get the uptick in her numbers in her PM cycle, just a continual decline. So my quandry is...if I shoot low to stay low, and there is no higher value in 2 hours (or when the Lantus kicks in), are we in trouble?
     
  9. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    No you aren’t in trouble. It just depends upon when you are ready to use those BOS’s!

    Why don’t you test her about 15 mins early and post so we can make a plan? I’ll be watching for you.
     
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  10. Margaret (and Pearl)

    Margaret (and Pearl) Well-Known Member

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    Thank you and I will write in 10 min with her value. What is a BOS?
     
  11. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    BOS= balls of steel :p:woot::woot:
     
  12. Margaret (and Pearl)

    Margaret (and Pearl) Well-Known Member

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    Marje! It is 8-fricking-7!! 87 @+11.75!! What in the heck do I do now? Is this a case of BOS or...no...?
     
  13. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    Breathe breathe

    Options:
    —shoot full dose on time and feed her a good MC meal

    —stall and retest in 20 mins without feeding. Can you shoot late and possibly make it up slowly? The only issue with this option is she’s likely to keep dropping so that you can’t shoot

    —shoot a reduced dose but she’s likely to do the same as option 1 for the first half of the cycle

    —skip

    All but option 1 are more for the CG than the cat so it depends on whether you have supplies and are available and able to test and feed. Could be a long night. If you decide to shoot, I’ll hang with you.
     
  14. Margaret (and Pearl)

    Margaret (and Pearl) Well-Known Member

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    Dec 23, 2020
    Ok, I have no idea how to handle it. In your experience which is the best choice for the cat and with the knowledge of how Lantus work which is best? Is it best to do the MC and stay on schedule OR skip? I do believe if I stall she will just keep dropping, so I don't know that the stalling option makes sense for me.I think if we do the stalling option, it will end up being a skip b/c she will keep dropping.

    Also what does CG mean?

    I'd like your opinion! (and lol don't worry I am breathing! Just a little freaked!)
     
  15. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    Are you still breathing? Oops....we cross posted.

    I’ve always been a shoot on time kinda girl unless I got 40s, of course. But you are the one that has to test and feed and potentially stay up. Best for her....shoot. But that doesn’t mean that’s what you HAVE to do if you feel you are not ready yet to shoot that low. I get it. There is no shame in skipping.

    edited to add: CG is caregiver. Sorry. I hate the term “owner”.
     
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  16. Margaret (and Pearl)

    Margaret (and Pearl) Well-Known Member

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    Dec 23, 2020
    Ok I will shoot if that's best for her. When should I take my first BG check? And thank you for staying me. Also, I took an AT reading - 103. Is that ok for shooting?
     
  17. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    Yeppers. 103 is good...so is 87.

    so now I get to say what we have fun saying
    SHHHHHOOOOOOOOOOTTTTTTT.

    Feed MC and test at +1. I’ll be waiting if you let me know exactly when you are done shooting.
     
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  18. Margaret (and Pearl)

    Margaret (and Pearl) Well-Known Member

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    I did it!!! She is happily munching her MC food (40g 13%), she would eat the whole can if I gave it - do I give her as much as she wants??. I was 7 min late shooting, so just finished.

    PS - my term is Pet Parent :)
     
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  19. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    Awesome and now you get your official BOS:

    upload_2021-1-25_17-12-5.jpeg

    Housekeeping...could you please update the subject line so everyone can admire your bravery and see how great your girl is doing! I’ll see you in an hour. Don’t panic if the number is lower but if she’s in the 40s, feed some HC before you post ;)
     
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  20. Missy & Tammy

    Missy & Tammy Well-Known Member

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    Dec 8, 2020
    Congrats Margaret & Pearl :bighug::bighug::bighug:

    You guys are in great hands.... I’ll be thinking of you tonight. Pearl will do awesome. And congrats on earning your BOS’s :joyful::joyful::joyful:

    I will probably be in your shoes one day soon as well :nailbiting: I would have made the same decision too I think. It’s scary but for the best if you want to progress.
    Have a GREAT night... we’ll be watching o_O
     
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  21. JaxBenji

    JaxBenji Well-Known Member

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    Jul 10, 2020
    Yay, congrats on shooting green! Soon it will be all you want to shoot :D
     
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  22. Hercule's mum

    Hercule's mum Well-Known Member

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    Hope the night is not too tough! Here is for many more greens!
     
  23. Margaret (and Pearl)

    Margaret (and Pearl) Well-Known Member

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    Dec 23, 2020
    Hi!! @Marje and Gracie Well believe it or not...+1 we are at 84. If we wanted her to go lower, I think I messed that up - she ate 50g MC (13%) food when I shot her. She just LOVES that stuff. Do I give MC still or go back to the LC now? And keep testing on the hour as I did last night? Thank you for your help!
     
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  24. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    I see an 84 at +1!!! I’d feed more MC because she hasn’t onset yet and she didn’t get a food spike. Test at +2. I’ll be here!

    We did not want her to go lower so you didn’t mess it up at all. We wanted to see a bit of a food spike.
     
  25. Margaret (and Pearl)

    Margaret (and Pearl) Well-Known Member

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    Dec 23, 2020
    Ok thank you I will test again in an hour. All 3 nights she went green, there has been no food spike yet. Maybe Pearl is broken?
     
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  26. Margaret (and Pearl)

    Margaret (and Pearl) Well-Known Member

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    Pearl would LOVE you! She is nuts about her MC food!
     
  27. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    I prefer to think of her as special! Her patterns are very much like Gracie’s but let’s hope she doesn’t like BGs quite as low.


    :woot:
     
  28. Margaret (and Pearl)

    Margaret (and Pearl) Well-Known Member

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    Oh this is YOOUUUU!!! Hi Tammy!! Missy is TOTALLY GORGEOUS!!!!
     
  29. Butters & Lyla

    Butters & Lyla Well-Known Member

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    Yaaaaaay!!!!!:D:D:D:D
    Congratulations! You did an awesome job shooting that 87. From an outsider's perspective reading your condo, looks like you were pretty calm about the whole thing. If you weren't feeling as calm as it seems, don't worry, it gets a little easier every time you shoot a green.
     
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  30. Margaret (and Pearl)

    Margaret (and Pearl) Well-Known Member

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    Thanks to Gracie for paving the path for Pearl! I just got her +2, we are at 99. Looks like she is following the same pattern of the last 2 nights so far. I'm thinking LC now, or more MC? You KNOW which one Pearl would choose ;)
     
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  31. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    Great on the +2! I would just give her a little bit of LC (sorry Pearlie) if she will eat. Just a tsp and test at +3. Let’s see if she will come back down slowly.
     
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  32. Margaret (and Pearl)

    Margaret (and Pearl) Well-Known Member

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    Hi Lyla! Thank you for your note! I was pretty wigged out, but at the same time I had a job to do - so I can turn the emotions down and stay logical ;) But don't be deceived - I am so wired I probably won't sleep tonight lol! I'm so glad it gets easier, it's just scary not knowing where the green will end up once you shoot it - and having the high patterns of bouncing around between hundreds of points, it's like "I don't have hundreds of points to mess with here" when we are green. But it's interesting how much LESS movement there is between large number changes at low numbers I am finding.
     
  33. Margaret (and Pearl)

    Margaret (and Pearl) Well-Known Member

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    OK sounds good. Talk to you in an hour! THanks!
     
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  34. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    You’re welcome. Shoot low to stay low ...remember? :D:D:D:D It gets phenomenally easier once the curves are flat like Butters and Henry.
     
  35. Margaret (and Pearl)

    Margaret (and Pearl) Well-Known Member

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    That is so crazy the way it works!
     
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  36. Butters & Lyla

    Butters & Lyla Well-Known Member

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    Marje is right it gets a lot easier. There is very little movement in Butters' numbers so whether I shoot a 100 or a 50 or anything in between, it doesn't really matter. Her cycles are all very similar. I don't think about it anymore; as long as she is 50 or higher green I just shoot without worry because her curves are the same regardless.
     
  37. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Congratulations on your BOS award Margaret! That's a very special award!!

    But beware....once you start shooting those greens, they become very addicting and even a low blue number can make you feel really disappointed.

    China eventually became the "Queen of green" and @Marje and Gracie was one of the people that helped teach me everything I know now!
     
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  38. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    Thanks, Chris. China was the Queen of Green and you did a great job with her. I use her SS often as an example of how Lantus can work.
     
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  39. Margaret (and Pearl)

    Margaret (and Pearl) Well-Known Member

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    Hi Chris and thank you so much for your message! LOL - I can't imagine getting disappointed with a BLUE PS, but at the rate things are changing around here, maybe that'll be next week ;) or like in 5 minutes?! LOL.
     
  40. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Just one thing....try to keep your subject line updated. It makes it a lot easier for people to scan the board and see how each kitty is doing, so tonight's (so far) should say 1/25, Pearl, PMPS 87, +1 84, +2 99......then keep updating as you get more tests in
     
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  41. Margaret (and Pearl)

    Margaret (and Pearl) Well-Known Member

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    Dec 23, 2020
    @Marje and Gracie Ugh, we are 120 now for +3. Maybe I gave her too much MC earlier? Or is this just her spike setting in? She didn't eat anything at +2 and still doesn't seem interested in eating more.

    Also - and maybe this is something to talk about another time not now - I've heard the ReliOn Premier is closer to a pet meter than some other human meters (closer than the ReliOn Prime etc). What is the ideal cat BG range we are going for? I might get in some AT readings when we are green to check on the comparison.
     
    Last edited: Jan 25, 2021
  42. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    It’s possible it was too much MC but it’s a learning curve and now you have some data. And maybe it’s also helped you with more confidence in shooting low. If she’d dropped like a rock, you’d have more trepidation next time but now you know what you can do to address it.

    I don’t know about the ReliOn Premier but it’s still a human meter so I wouldn’t worry about it’s readings compared to the AT. It’s hard for us to get rid of our reliance on the AT but I wouldn’t worry about doing comparisons. You can look at Gracie’s tab as I did ReliOn Micro and AT comparisons just so members could see it’s all over the place. Today a 102 on the AT might be an 84 on the ReliOn. Tomorrow it could be totally different.

    Normal numbers are 50-120 on a human meter but we strive to keep them mostly in the 50-99 range with just a few lower blues here and there.

    You can just grab a before bed test as long as it’s 2-3 hours. Tell her I’m sorry about no more MC.
     
  43. Margaret (and Pearl)

    Margaret (and Pearl) Well-Known Member

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    Dec 23, 2020
    HI and thank you for writing and for all your help. I am really so shocked she DIDN'T drop like a rock! So this is now 3 green nights, and 3 nights she didn't drop like a rock. It's building my confidence little by little.

    Thanks for the note about the meter comparisons - I started a chart like you used for Gracie, so whenever I happen to take AT readings, I will populate my comparison chart. And yes, I have noticed what you said - that the comparison isn't reliable over different days.

    I will plan to test her in 2-3 hours, can I do LC then or would it be best no more food for tonight? She did have a good amount earlier, it would end up about 40g less than her usual at night if I don't feed her at all until AMPS. What do you think?

    I hope you have a good night Marje!
     
  44. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    It’s fine to give her the rest of her LC food if she hasn’t had her full portion. You can give it to her at anytime.

    Every cycle teaches us more. It’s early yet for her and soon, you’ll know exactly what to feed when. You did great tonight and she’s doing well.

    Sleep well...now time for me to cuddle my little foldies!
     
  45. Margaret (and Pearl)

    Margaret (and Pearl) Well-Known Member

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    Oh you have FOLDS?! How UBER CUTE!! Thanks for everything, Marje :kiss:
     

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