? Pre shot levels of 72, help?

Hi,

So i woke up this morning and tested sam. He was at a 72. I had reduced his dose from 3 to 2.75 last night. Not sure what to do anymore. Haven’t shot, i just dont know why he fluctuates so wildly.

 

I'm not experienced to tell you what to do. I would put the ? Prefix at the beginning of your post to get attention quicker.

I can tell you don't feed & don't shoot & test again in 20mins & wait for help.

 

Retest in 20 minutes which should be in about 7 minutes and post his number again. You may want to give him a token dose instead of 2.75. Unless you’re able to be home and monitor the rest of the day. In any case, this is good news and he earned another adjustment down to 2.5

 

Tagging the pro who held my hand through shooting at the low numbers @tiffmaxee

 

Question, why did you go up from 2 units to 2.75 yesterday? Lantus needs consistency and you should try to stick with a dose for a week or so. This may be why he’s at 72 this am. The 2.75 is too high a dose for him

 

Because he was at a 90 and i had to go to work all day. He’s consistently been on 3 for over 5 weeks. Over at the lantus forums i was told that was fine, and to reduce his dose from 3 to 2.75. I just didn't want to come home 8 hours later and have him be dead or something.

 

Did you shoot the 2.5 units?

Refresh my memory. When did you start feeding low carb?

 

He's been on a mix of 18% dry food and half low carb wet until about 3 weeks ago, I gradually transitioned him off of the dry food (he gets some as a treat sometimes). I did shoot the 2.5

 

Thanks.

Did you give insulin? Or take any tests after the pre-shot 72?

 

@chuckstables
I cannot stay online so I'll quickly cover what the day might be like if you shot.

If you have given insulin, you should monitor closely. To start, get a +1 and +2. If either is somewhat the same or lower, it could be an indication of an active cycle.
If the numbers are above 50, feed small amounts of low carb food.
If the numbers are below 50, it's time to bring out the big guns.
Then test every hour.

Please post your numbers so that someone can jump on board and help you if needed.


Do you have plenty of strips? Hypo kit?

If you have not given insulin, can you please go to your spreadsheet and change the 2.50 to "ns" (no shot)?

 

Yeah I gave him his insulin. I tested him before, and his levels were above 100, so that's fine. I'll test him again at +3. I need to limit the testing with him; he absolutely hates it and gets scared of me. I try giving him the chicken breast I cooked at test time.

 

My question is why did you go from 2units to 2.75 & then 2.5 this morning? You should have stayed at 2.0.if not 1.75. Anything under 90 is a dose decrease, not sure if you can take a back to back reduction but you should definitely not have increased. @Suzanne & Darcy @FrostD @Bandit's Mom

 

That was my question exactly. 2 units should have been the dose. At any rate, nothing we can do now but let’s stay at 2.5 to see what happens please! And yes, you can earn back to back reductions. Anytime you get an under 90 you reduce. Unless you’re following tr but with the dry food you can’t

 

I want to offer a couple of observations.

Decide where you want to post. Personally, I would recommend the Lantus forum, but that's your choice. There's a good chance your going to get conflicting information if you post in both Health and Lantus. (e.g., people not going over to the Lantus forum and reading what was posted there yesterday).

If my crystal ball worked, I'd have guessed that Sam's numbers were in the greens last night -- his numbers dropped after your +3. This is indicated by his AMPS today. It's really important that you start getting more tests. This is especially the case with a lower pre-shot. With a pre-shot of 72 and not having much/any data to guide you, there's no telling how low Sam's numbers went. Looking at the thread you posted on the Lantus forum, I thought you were going to get a curve today.

I would stick with the 2.5u dose. I realize Wendy suggested 2.75u but that was before your AMPS of 72. If you're not comfortable with 2.5u, then drop it back to 2.25u but you need to find a dose you can stick with. If you're following SLGS, you will need to hold that dose for a week. With TR, you would hold the dose for at least 3 days.

Also, a reminder... Lantus dosing is based on the lowest number in the cycle and not on the pre-shot numbers. I know you want to minimize testing -- at least until Sam decides you're not trying to torture him. However, what he wants and what will keep him safe may contradict each other. You need to test at pre-shot and at least once during both the AM and PM cycle - thus, at least 4 times a day. Getting a curve will tell you when Lantus onset and nadir typically occur. That is also important information. If you need to adjust dosing on a cycle by cycle basis, Lantus may not be the best choice of insulin. Lantus needs a minimum of 3 days of consistent dosing (barring the need for a dose reduction) for the depot to stabilize after any change in dose. Frequent changes in dose will give you wonky numbers.

 

Well at +3.5 he's even lower, at a 66 now. I'm giving him some higher carb dry food to try to raise it up.

 

He has been at a stable dose until I started testing and as per the SLGS protocol I have to lower it. I just tested at +3.5 hours, and he is now at 66. Feeding some high carb dry food, will monitor and retest in 2 hours.

 

My approach would have been different.

• I never used dry food to steer lower (or very low) numbers. I'd put Sam's 66 in the "lower" category. Dry food takes too long to have an effect. Using the "gravy" from many of the higher carb foods (e.g., Fancy Feast Gravy Lovers) or if your cat has a gluten sensitivity like mine did, I would use either corn syrup or honey. Both of these options act much more quickly to bring numbers up. I would use only a drop or two of syrup. You don't want numbers to sky rocket -- you want to nudge them up.
• I would test frequently. If you look at Gabby's spreadsheet, if numbers were low and dropping, I was testing every 15 - 20 min, 30 min. at the max. Delaying by 2 hours between tests means that Sam could be sitting in the 20s or 30 and you wouldn't have caught those kinds of lows unless he was exhibiting very worrisome behaviors.

You may want to take a look at this post on handling low numbers.

I'd also urge you to think about getting an additional test when you saw that 67. The information in your comments suggests that you did keep an eye on things but there's nothing on Sam's spreadsheet at PM +4.

 

I just did one more test at +7.5. He was 2.8. This is kind of an emergency; I've given him wet food with some karot syrupt mixed in. Will retest in 30 minutes.

 

Sienne is right about the forums. In the Lantus forum you’ll get more immediate responses, especially if it’s an emergency. I would repost there.