10/14 Blizzard PMPS 106 Stalling

Discussion in 'Lantus / Levemir / Biosimilars' started by Hilary B, Oct 14, 2021.

  1. Hilary B

    Hilary B Member

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    Oct 5, 2021
    My 15 year old boy was diagnosed two weeks ago. He is on .5 units of Lantus every 12 hrs. He’s only been on Lantus for about a week. His preshot numbers have been lower than I’d like. I’ve read up on TR and gathered some data. Looking for some advice.
     
  2. FrostD

    FrostD Well-Known Member

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    May 27, 2020
    Do you have any specific questions?

    I'm assuming you mean you read the dosing sticky. When first starting, it does recommend if you get a preshot lower than 200 mg/dL (11.2 mmol) to stall without feeding and post here for help. What times are your shot times, including time zone? Chances are there will be people around to help guide.you if uncomfortable.

    His numbers actually look really good, especially for a newly diagnosed cat and at such a low dose!
     
  3. tiffmaxee

    tiffmaxee Well-Known Member

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  4. Hilary B

    Hilary B Member

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    Hey there! Thanks for getting back to me! He seems to have much lower numbers at PSPM than PSAM. Is that normal? How long should I stall for? Until he gets to 11 mmol? I shot last night at 7.7. Do you think that was too low to shoot at? I'm just wondering if he gets such low pre-shot numbers continuously in the future should I decrease his dose to .25? Not sure I can accurately do that on a syringe! Thanks in advance.
     
  5. tiffmaxee

    tiffmaxee Well-Known Member

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    How off schedule can you be? Will you be able to monitor tonight as late as needed? Did you switch from dry food or from a higher carb canned? It’s very common for cats to be lower at night. There’s many pj parties here.
     
  6. Hilary B

    Hilary B Member

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    His PMPS is 5.9. I usually shoot at 8:30 MST. I'm on maternity leave so can be flexible with my schedule. He is on Fancy Feast pates.
     
  7. tiffmaxee

    tiffmaxee Well-Known Member

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    You haven’t shot this low. Stall. Don’t feed and test in 30 minutes. While you are wait please change your subject bar to our format.

    10/14 Blizzard PMPS 106 Stalling
     
  8. FrostD

    FrostD Well-Known Member

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    Elise @tiffmaxee are you able to stay with her? I was just about to head to bed.
     
  9. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    I’ll watch for awhile and get Bhooma to take over. Good night Melissa.
     
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  10. tiffmaxee

    tiffmaxee Well-Known Member

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    Please test again.
     
  11. tiffmaxee

    tiffmaxee Well-Known Member

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    Have you tested? Did you shoot ? It’s getting late for you and if he’s not going up he might go a lot lower without food. Please let me know whether you shot.
     
  12. Hilary B

    Hilary B Member

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    Oct 5, 2021
    hey there, so sorry. He is now at 6.8. Any thoughts on what I should do?
     
  13. Hilary B

    Hilary B Member

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    I did not shoot
     
  14. Bandit's Mom

    Bandit's Mom Well-Known Member

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    Oct 18, 2019
    How long after your shot time was he 6.8? Was it after food?
     
    Last edited: Oct 14, 2021
  15. Hilary B

    Hilary B Member

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    I haven't shot yet. It's now been 13 hrs since his last shot. He has only had a few small pieces of dehydrated liver (as treats for testing).
     
  16. Hilary B

    Hilary B Member

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    He is quite hungry
     
  17. Bandit's Mom

    Bandit's Mom Well-Known Member

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    If you can monitor and the delay does not affect your schedule, you can go ahead and shoot.
     
  18. Hilary B

    Hilary B Member

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    Oct 5, 2021
    K I'll shoot. I'll keep you posted. I think he should be fine. His numbers are increasing and he is very hungry. Do you think there's a possibility that his dose is too high? This is the second night he's had low preshot numbers.
     
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  19. Bandit's Mom

    Bandit's Mom Well-Known Member

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    Oct 18, 2019
    Get a test at +1 and +2 and post here. He might just head up. Let's see.

    Hard to tell yet. It would be good to get at least one test per cycle to see how low he is going.
    I would suggest you shoot if you can monitor and let him earn a reduction by dropping below 2.8.
     
  20. Hilary B

    Hilary B Member

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    When you say "per cycle" do you mean every hour?
     
  21. Bandit's Mom

    Bandit's Mom Well-Known Member

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    No. A cycle is 12 hours - the time period between shots. There are 2 cycles in a day - AM and PM.
     
  22. Hilary B

    Hilary B Member

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  23. Bandit's Mom

    Bandit's Mom Well-Known Member

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    Yes, I saw your SS linked in your signature. I was suggesting getting a test every day (if possible) between shots to see how low he is going.

    He could start high and dip pretty low - like you saw on 10/5. A high preshot is not an indicator that he will stay high through the day/night. The idea with getting mid-cycle tests is to see how low he is going on a dose. Lantus dosing is based on nadirs. If he dips below 2.8, the dose is too high for him.
     
  24. Hilary B

    Hilary B Member

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    Is it ok to have a nadir in the 4's mmol? What should an optimal nadir number be?
     
  25. Bandit's Mom

    Bandit's Mom Well-Known Member

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    Yes. The range for normal blood sugar for a cat is 2.8 to 5.5 mmol on a human meter. A cat is said to be in remission when it can stay in those numbers without insulin.
    Our aim is to keep the cat at a dose where it spends it's time in green - that's when the pancreas heal.
     
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  26. Hilary B

    Hilary B Member

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    he's at 7.2 mmol at +1. i think we're good. thats so much for your help
     
  27. Bandit's Mom

    Bandit's Mom Well-Known Member

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    That is the food bump. Best to get a +2 and +3 to ensure he doesn't drop once the insulin onsets which is typically around +2 for Lantus.
     
  28. Hilary B

    Hilary B Member

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    Oct 5, 2021
    He is at 6.2 mmol at +2
     
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  29. Hilary B

    Hilary B Member

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    Oct 5, 2021
    At 5.9 mmol at +3. Heading to bed. Thanks again!
     
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