? 8/23 amps 333, +8 199, pmps 169

Discussion in 'Lantus / Levemir / Biosimilars' started by Wendy Jones, Aug 23, 2020.

  1. Wendy Jones

    Wendy Jones Member

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    Jun 6, 2020
    OK so Tiger has been bouncing high for nearly a week. Today was his first day to lower. I took his BG before dinner and got 169. I honestly thought the rule was to shoot full amount unless it was below 150. I gave him his 3 units and then I thought it about it some more and went back to read the guidelines again discovering i should have lowered his dose. How dangerous is it to give 3 units of Basaglar at 169? I rechecked him two hours after shot and he's 222 but that's after he ate dinner. I just fed him a tablespoon of higher carb wet. Can I keep feeding him small amounts of the gravy wet to help keep his BG up tonight or should I do something else?
     
  2. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    It’s not that shooting a full dose is dangerous with a bg of 169. It’s not when you have data. When shooting a bg lower than you ever have before we ask you to stall, not feed, and post asking for help. Then someone will guide you. I would get a +4. Please take down the 911. It’s reserved for when a cat is dropping really low or a medical emergency. You already shot and Tiger is safe. The prefix to use in this type of situation is “? “ I know you were scared. Congrats on a blue PMPS. That’s good progress.
     
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  3. Wendy Jones

    Wendy Jones Member

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    Jun 6, 2020
    . I wasn't sure if I should start feeding high calorie now or do something else since I shouldn't have given him the full dose. I'm really worried about his nadir tonight. Do you say he's safe because his +2 was 222? That means he'll most likly raise a lot more before the shot takes effect?
     
  4. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    You don’t want to feed high carb food. Here’s the thing. He was lower than your previous test at PMPS. The right thing to do is to stall, DON’T feed, and get another reading in 20 minutes. Meter variance is 20% so they weren’t far apart and maybe that was a bad strip. You already shot the full dose so we can’t take it back. You dint want to shoot a falling number. Tiger got a food bump which is good. Get a +3 and I’ll tell you more. In the meantime if I were you I would print out the SLGS instructions and the one in what to do if you get a lower than normal pretest. I followed TR but printed out the other instructions that I had to read over and over when Max would drop at midnight and I couldn’t get help.
     
  5. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    Those "no shot" and "token dose" limits are more for people who don't have much data or experience (or can't test as often as might be necessary for that cycle) Once you have enough data and a better understanding of how the insulin works in your cat, the PS numbers you're willing to shoot can start to come down. On SLGS the one thing you don't want to shoot is a PS under 90.

    All that being said, if you're doing SLGS, you need to do a curve soon. You've been on the 3U dose for 10 days. You should be doing a curve every 7 days (a curve is testing every 2 hours for 12 hours or every 3 hours for 18 hours)

    Save the high carb food for when you really need it....which isn't until he drops below 50

    If he's dropping fast, you can use a little medium carb to try to slow him down first (if you don't have anything medium carb, you can mix high carb with low carb to get medium carb)

    Basaglar actually works best when it doesn't have to pull down a high number so shooting those higher blues is really a gift....although a scary one at first!
     
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  6. Wendy Jones

    Wendy Jones Member

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    Jun 6, 2020
    I've read it about 10 times this evening trying to make it stick! Lol. I would prefer to do TR but I don't see how I can when he's not yet had a level reading i could count on. I'm confused about the stall. You wait 20 minutes and test again then wait 20 more if it's still low but at what point do you skip and go ahead and feed? I was told not to shoot more than an hour late. Also if you skip doesn't that mess up their cycle?
     
  7. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    Had you asked before you shot I would I had you shoot. Read what Chris wrote above. I would have told you to get a +1 and+2. You need to do a curve to see about dosing.
     
    Last edited: Aug 23, 2020
  8. Wendy Jones

    Wendy Jones Member

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    Jun 6, 2020
    I don't feel like I have good data on Tiger yet. Seems like each time he hits a lower number he bounces. I moved him up to 3 units and two days later he bounced and stayed 300-400 so I was waiting for him to clear before I did a curve cause I didn't think a curve would be useful willie he was bouncing. Today was i think him clearing the bounce so when I got the 169 I was afraid to skip the dose and create another high. I really wanted to see what his full dose would do but then I scared myself and thought maybe I needed to head off a hypo early by feeding gravy wet. Not sure if that's high carb or medium carb though. I should just stop letting myself get freaked out. I read the post where that lady or her mom shot too low and couldn't save the poor cat. I can't let that be me.
     
  9. Wendy Jones

    Wendy Jones Member

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    Jun 6, 2020
    He was 336 +4
     
  10. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    You are fine to stop testing for tonight.
    He would have to go under 50 and more likely under 40 for a symptomatic hypo. Lantus onsets between +2-3. High carbs are reserved for a drop under 50. Middle carb might have been suggested had your +3 been a lot lower than you PMPS. Otherwise lc is used.
     
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  11. Wendy Jones

    Wendy Jones Member

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    Jun 6, 2020
    I've been reading about where you shoot effects how fast the insulin works. I've always shot him in the scruff. He doesn't mind that but cried when I tried his hip area. I've noticed when I do get a low number it seems to be late in the cycle. Do you think that's due to the scruff shot? If so should I shoot somewhere else to get a faster reaction or does it not really matter and it starts within 2-3 hours no matter where I shoot?
     
  12. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    I know it can be really scary, but anytime you're in doubt, stall, DON'T feed and test again in 20-30 minutes....if the number goes up, it's usually fine to go ahead and shoot because the last shot is starting to wear off.

    Use that time to post with a very clear subject line like "STALLING! NEED HELP!".....That usually grabs somebody's attention and once you have help, you can edit your subject line.

    We have a tradition here....if somebody encourages you to shoot a lower number you're not sure about, they will stay online to watch for updates for as long as necessary. Many of us have stayed up all night with someone to make sure they were comfortable and their cat was safe. If they can't stay online, they'll tell you up front so you can make an informed decision about shooting. If someone starts out with you, they'll either stay with you as long as needed or find someone else with experience to take over. You won't be left alone.
     
    Last edited: Aug 23, 2020
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  13. Wendy Jones

    Wendy Jones Member

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    Jun 6, 2020
    Thank you!
     
  14. Wendy Jones

    Wendy Jones Member

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    Jun 6, 2020
    Thanks for your help!
     
  15. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    I read tgat also so I shot Max on his side or belly. He never minded the shots.
     
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  16. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    I shot around the shoulders for five years. I did try a few flank shots - she wasn’t a fan! It didn’t make any difference in her numbers. You might have to try and see what works for Tiger. Maybe higher up the sides towards his front legs if the hip area is a no go.
    there’s a difference between calorie and carbs. Usually a higher calorie food has more fat, and is good for putting weight on, if that is what kitty needs.
     
  17. Wendy Jones

    Wendy Jones Member

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    Jun 6, 2020
    Sorry I meant high carb but thinking about it now I didnt know the difference between carb and calorie. I have been using the cheat sheet on the brand list.
     

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