? 5/31 Jessi PMPS 245 +4 171 +6 154 AMPS 227 132@+2.5 ...76@+5, 67@+7.5...we earned a reduction!

Discussion in 'Lantus / Levemir / Biosimilars' started by Stefania S, May 31, 2023.

  1. Stefania S

    Stefania S Member

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    May 2, 2023
    https://www.felinediabetes.com/FDMB...essi-pmps-228-56-4-410-10-no-appetite.278067/

    Hi all, I'm happy to be here!

    Since it is time sensitive, shot time is now, could I ask for your opinions if I should wait a little longer to get the PS up more or go ahead and shoot.

    [Update: Preshot just went down instead of up, now it's below 200 on the Libre]

    Just took a reduction yesterday 5/30 from 1.5 to 1.25 Lantus, after a pretty big dip to 56 on the Libre Sensor

    Will write with more questions soon, this is what I need to know right now.

    Thanks so much!


    BTW, will fix up my Signature today. Time zone is Central European Time, can't remember if I put that in my profile. Will check today.

    Stefania
     
    Last edited: May 31, 2023
  2. Bandit's Mom

    Bandit's Mom Well-Known Member

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    Oct 18, 2019
    Only just saw this! Did you shoot? With SLGS you can shoot any number over 90, if you can monitor.
     
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  3. Stefania S

    Stefania S Member

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    May 2, 2023
    I did shoot, though I waited a little first. I guess I'm being overly cautious. Unfortunately, because of too many moments like this the hour keeps getting later instead of earlier. But, I'll slowly get it back to a better time...I hope...

    Why did I think the minimum preshot for SLGS was 200?

    90??? That's scary! :nailbiting: If I shoot at 90 isn't that going to mean will be in super low numbers really fast? Educate me because Lantus is like deep jungle to me, I have no idea what's going to happen next! Caninsulin was so predictable by comparison, maybe the only thing about it that was better, and the better smell too.

    Good news is that we've gotten to the point where Jessi is actually purring while I'm giving her the shot and doesn't even notice!!! YEY!

    I will definitely be monitoring closely today, as usual. This is my full-time job! Lol!
     
  4. Bandit's Mom

    Bandit's Mom Well-Known Member

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    Oct 18, 2019
    That's great! :woot:

    You can move shot time earlier by 15 mins per cycle. So if you shot at 10am this morning, you can shoot at 9:45 pm tonight, 9:30am tomorrow morning and so on.


    For members whose cats are new to insulin and who don't have enough data on how their cat responds to the insulin, we suggest not shooting below 200. With time, you want to lower the number you can shoot to 90 on SLGS and 50 with TR. Lantus is good at giving flatter cycles when you shot lower preshots. The below SS is one recent example of a cat's numbers becoming flatter and flatter till you can shoot green and still not worry:
    https://docs.google.com/spreadsheet...41CqUI-xZ6Rr8M9g55XPkwygtcX-E3sbtQX5W/pubhtml

    Feed small snacks (like a tsp of her usual food) at +1 and +2.
     
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  5. Stefania S

    Stefania S Member

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    May 2, 2023
    Ok, got it. I guess we both have to get more comfortable with the lower numbers.

    Yes, I was going to move shot time up by 15 minutes in the AM but then I hesitated and lost the chance. I'll try again tonight.

    Thanks for the spreadsheet. It helps to have a visual and see how others use the spreadsheets. Boy, if I start writing all that stuff in I'll be sitting here all day! Don't get me started!

    Still, it would be good to include food and snacks, some description of her behavior, appearance, appetite, etc...I'll start doing some of that.

    It's crazy how little sleep folks, including myself, are getting, especially in the early stages. What we do for our feline friends...:cat:
     
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  6. Stefania S

    Stefania S Member

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    May 2, 2023
    I sure could use someone to hold my hand if/when preshots are low and especially when we hit super low numbers in the middle of the night! Yipes! It's hard to go through that alone.

    I hope I get lucky next time these happen and find people like you online at just the right moment!
     
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  7. Stefania S

    Stefania S Member

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    May 2, 2023
    Numbers have been hovering in the low to mid hundreds all day, now just rechecked by chance and saw 76 @+5 and falling according to the Libre!

    She ate a half can about 15 minutes ago and is eating the other half now. I gave snacks throughout the day, but maybe a few too many hours went by since the last snack. Normally she would have a full meal at around +5/+6 as per our usual routine, but the hours got a bit messed up so maybe her body was looking for the extra glucose and not finding it?

    So this means we earned another reduction of .25, right? or is it too close to 90 given that the Libre is usually a bit lower?

    Next shot in 4.5 hours will wait to hear back from you all if I should reduce or not.

    Thanks!
     
    Last edited: May 31, 2023
    Reason for edit: Reduction???
  8. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    Congrats on the reduction earned by the bg dropping under 90. It’s a nice safe number. Starting tonight her dose will be 1.0.
     
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  9. Stefania S

    Stefania S Member

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    May 2, 2023
    Thanks, but now it's at 67 :nailbiting:

    when do I start giving her MC or HC or big guns?

    She looks like she feels really unwell
     
  10. Bandit's Mom

    Bandit's Mom Well-Known Member

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    Oct 18, 2019
    @tiffmaxee and @Angela & Cleo are in the US and should be around in the night for you, since you're a few hours ahead of the US.

    Stay with LC for now. 67 is at +5.5?
     
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  11. Stefania S

    Stefania S Member

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    May 2, 2023
    +7.5 or so
     
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  12. Stefania S

    Stefania S Member

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    May 2, 2023
    She just ate a whole can of LC about 30 minutes ago, it doesn't seem to be having much effect

    Wait, now it's showing me 104
     
  13. Bandit's Mom

    Bandit's Mom Well-Known Member

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    Oct 18, 2019
    That's the Libre for you! o_O
     
  14. Stefania S

    Stefania S Member

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    May 2, 2023
    Right, so which is it? :confused:

    Jessi look so unwell right now...and her ears are kind of warm, like she's heating up. Can that happen with low BGs?

    Poor love, it doesn't help she has several other conditions at the same time...

    So no carbs for now I guess....
     
  15. Bandit's Mom

    Bandit's Mom Well-Known Member

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    Oct 18, 2019
    Till they get used to lower numbers, they can feel a little strange in them. It's not that they are unwell. It's like a caffeine withdrawal. Or like going off sugar. Once their bodies get used to lower numbers, they love them and the reverse happens. They start feeling uncomfortable in high numbers.

    No. In fact you can stop feeding her for now.
     
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  16. Stefania S

    Stefania S Member

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    May 2, 2023
    Numbers are going up now, already at 170 according to the wiley Libre :D

    Phew! We made it through this one without any carbs or sugars!
     
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  17. Stefania S

    Stefania S Member

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    May 2, 2023
    Ok, I won't feed her until shot time, as long as numbers stay up. Hope she eats after this! Really she started eating at about +6 so it took a while for the food to change the BGs significantly. I often see much faster effects from the food making BGs spike within a few minutes even.

    So tonight I give 1.0u all agree?
     
  18. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    You don’t want the food to change the BG significantly. Surfing green is healing for the pancreas. You just don’t want her going under 50. When that happens you feed hc to bring it up. Lantus is known for nice flat cycles. It’s why many follow TR. once regulated the BG is flat. I know you are following SLGS so you want to keep her over 90. Hopefully this makes sense.
     
    Last edited: May 31, 2023
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  19. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    From the dosing methods sticky:


    Hold the dose for at least a week:
    • Unless your cat won’t eat or you suspect hypoglycemia
    • Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
     
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  20. Stefania S

    Stefania S Member

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    May 2, 2023
    So until we do TR her pancreas won’t really be able to heal, is that it?

    I’m still trying to understand why these sudden big dives happen, especially since Lantus is supposed to be so much gentler and make flatter curves, like you’re saying. What makes that happen? And why do they happen often hours before or after the nadir?


    So we go to 1.0 tonight, second reduction in a row! This is a good thing, right?
     
  21. Bandit's Mom

    Bandit's Mom Well-Known Member

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    Oct 18, 2019
    Not necessarily. Some cats are able to do well on SLGS too, but TR is a more aggressive dosing method. For now Jessi seems to be working it. At some point if you feel like you want to switch to TR, you can always do that in the future.

    I'm not sure how much of these late cycle dives and then jumps is just Libre wonkiness.

    Yes. Down to 1U from tonight.
     
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  22. Stefania S

    Stefania S Member

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    May 2, 2023
    If so, that's a lot of wonkiness!

    But if it's the Libre doing that then how do we know a reduction is called for? Maybe it never went below 90...

    Sorry, maybe I'm just asking too many questions at this point. I'll go with the reduction, it's a relief anyhow.

    PM preshot is bound to be on the low side. Usually by now here BGs would be in the upper 200s and moving into 300s...but now they're still around 175

     
  23. Bandit's Mom

    Bandit's Mom Well-Known Member

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    Oct 18, 2019
    She is headed up and she will bounce from the greens she saw today. Take the shot.
     
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  24. Stefania S

    Stefania S Member

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    May 2, 2023
    Oh no, I thought I had posted this last night. Sorry about that!

    Done, I'm almost sure...I always have a doubt. I was supposed to do the shot earlier, but just when it was time I couldn't find Jessi, and when she finally appeared she was vigilant and tense, not the purring, distracted cat I told you about earlier. And this time she felt the shot, darn it! I shouldn't have said anything to anyone about how well it was going, I think I jinxed it! :banghead:

    Oh well, we'll do better next time.

    Preshot was 220.

    Too bad I couldn't get it done earlier, I have to leave the house tomorrow morning right around the time of the shot. Scheduling is not so easy these days. I have to think about what times is safe to leave and for how long. I hope things get more stable because even though my lifestyle allows me to spend a lot of time at home with her, I actually do have other things that I need to do.
     

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