? 10/28 - Wally - dosing advice: AMPS=145,+1.5=240,+8=48,+8.5=73,+9.25=97,+10=123,PMPS=275,+2=406

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by Ginger Cat, Oct 28, 2020.

  1. Ginger Cat

    Ginger Cat Member

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    Nov 2, 2017
    I was taking part in a spay/neuter clinic and luckily we got through early so as soon as I got home I tested Wally and he was down to 48! Not showing obvious signs of hypo other than screaming for food. I opted to give him his usual FF and some Young Again dry. He went up to 73 within 30 minutes and I'll continue to test/feed, but do I not shoot tonight or give him a reduced dose?

    This is now the 2nd time he's hypo'd when he is on 2 units BID. But - looking at his spreadsheet he has had some great numbers at 2 units so it's so frustrating...

    You'd think, after 3 years of doing this sugar dance, I'd have more insights/confidence in dosing, but I welcome your recommendations.

    Last thread: https://www.felinediabetes.com/FDMB...122-5-344-pmps-364-2-397.237573/#post-2667791

    Gita
     
    Last edited: Oct 28, 2020
  2. Ginger Cat

    Ginger Cat Member

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    Nov 2, 2017
    he's up to 123 +10 and that's without any additional food since his 9.25 reading.
     
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  3. Vyktors Mum

    Vyktors Mum Well-Known Member

    Joined:
    Nov 15, 2011
    So first I’d like to adjust the terminology a little. Wally didn’t hypo today he just had a low number. A non-diabetic might occasionally read that low (they would on a human meter not so sure about the Alphatrack) but with insulin on board we need to take action to make sure they don’t keep going lower and actually hypo.

    Most cats go higher with stress from something like a vet visit but there’s the odd cat that likes to go lower instead. Have you been able to note any previous examples of this in Wally’s time on insulin?

    Also with TR you don’t want to be using any dry food unless it’s an absolute emergency. Ideally you would have given a teaspoon or two of HC wet food for the 48.
     
  4. Vyktors Mum

    Vyktors Mum Well-Known Member

    Joined:
    Nov 15, 2011
    I think you’ll have to reduce for safety even if he is a low number stresser but I would think just by the usual .25. He came up pretty easily and remember- you want to shoot low to stay low on lantus. Of course he may be bouncing by PMPS anyway ...
     
  5. Ginger Cat

    Ginger Cat Member

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    Nov 2, 2017
    Wally wasn't at the spay/neuter clinic - just to clarify. I was volunteering so I wasn't home to do my usual nadir test. And - he doesn't stress out at the vet's unless there are dogs barking because he hates dogs. Normally his numbers, when tested at the vet's office, are pretty good. And, with the AlphaTrak, numbers below 68 are considered hypo range. The dry is the Young Again Zero Carb and he always gets a couple of pcs as a treat after his tests. I maybe gave him 10 pcs total when he tested so low.
     
    Last edited: Oct 28, 2020
  6. LindyNova

    LindyNova Well-Known Member

    Joined:
    Nov 11, 2019
    Wally earned a reduction regardless of using the AT2, unless you are going with the 3 under *whatever number* (68?) with the AT2 because of long term Dx. I would reduce by .25.

    I agree on both counts...just a low number and "hypo" under 68 on AT, but many cats, mine included, have gone below the intended cut-offs with either human or feline meter without any symptoms (besides major hunger). I hope someone else will chime in.....but that's my take on the sitch. :)
     
  7. Christie & Maverick

    Christie & Maverick Well-Known Member

    Joined:
    Aug 1, 2017
    Well, I have to say Wally sure likes to keep you guessing! I've been doing this for a few years too, and some of his cycles are definitely not your typical on Lantus. What is your feeding schedule like?

    Having been also a die-hard AT2 meter user, I'd suggest you consider selecting what your reduction point, one under number will be. I used to use 60. 48 is getting down there, and to be honest, that came out of nowhere. After seeing a +2 like you did today I wouldn't have bet any money he'd be getting a 48 but he did.

    The other thing I noticed is he seems to like nadiring later in the cycle. Which is why I asked about feeding schedule, you may need to experiment a little to see if giving snacks later in the cycle helps to flatten things out. He then goes into what seems a short bounce, then clears.

    I'd take the reduction.
     
  8. Ginger Cat

    Ginger Cat Member

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    Nov 2, 2017
    Okay - he's up to 275 PMPS, without the influence of food for almost 2 hours so I'm going to give him 1.75 and continue to test tonight.
    Interesting that you say this because my vet is convinced that he is actually on an 18 hour vs 12 hour cycle, but trying to dose based on that would be impossible. I do tend to give him little FF snacks throughout the day and today, because I left the house at 10:30 am and didn't get home until close to 5 meant that he didn't get any food. This goes along with why he seems to have low AMPS numbers since he's been fasting overnight as well.
     
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  9. Christie & Maverick

    Christie & Maverick Well-Known Member

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    Aug 1, 2017
    I like giving some mini snacks at night, at least for the first part of the cycle. Many cats do like to go lower at night, so that might be something you can try. Even something before you go to bed? You do test most evenings, so something to ponder, maybe giving some higher LC around +4 or +5? As I said it would be a bit of an experiment, I'd sure like to see him flatten out a little.
     
  10. Ginger Cat

    Ginger Cat Member

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    Nov 2, 2017
    He gets his shots at 8:30 am/pm and I do try to give him some FF before I go to bed, around 10:30/11 pm. He just tested at 406 so I'm sure that's a bounce from today's low. I did give him some FF just now. It will be interesting to see his AMPS number.
     
  11. Ginger Cat

    Ginger Cat Member

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    Nov 2, 2017
    His AMPS number this morning was 273 so that's a nice drop from last night...
     

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