This 373 reading is almost 2 hours since being fed while yesterday's was fasting.I'm gonna be brutally honest with you, he probably did, we just don't know about it due to the lack of data/tests. But he's clearly been riding them out like a wee champion he is!Their bodies know something is wrong, and when they drop to dangerously low levels they either
a) intuitively seek food to bring their BG up [is there a possibility he'd eat on his own without your knowledge e.g. when you're asleep?]
b) their liver "panic" and secrete extra glucose.
The suggestion to lower his humongously high dose drastically was based on him giving very inconsistent BG values - to me it looked like he was "bouncing" - dropping low, then bouncing sky high as a result of his panicky liver.
I'm incredibly happy for you have being able to get a test for first try! It'll become easier, once his blood is less concentrated/clogged with sugar, allowing for easier blood flow.
Plus clearly your patience and persistence is paying off, too!
You were meant to decrease by 0.25 IU, so his dose should've been 0.75 IU. Let's see what he gives you for AMPS. Hopefully it's another blue, then you'll know your judgement of injecting 0.5 IU was correct.
However, looking at his sheet where you shot a blue with 0.5 IU, the following PRE was yellow, which makes me think he'll give you a yellow AMPS again.
With that said though, Lantus likes consistency, so perhaps it would be best practice to keep with the 0.5 IU for the next at least 5 cycles.
In these upcoming 2 days, could you perhaps buy a digital caliper, which would allow you to measure out 0.25 units?
Well done Mike and little Dude, you've got this!![]()
This 373 reading is almost 2 hours since being fed while yesterday's was fasting.
I have to feed him when he seems hungry. Sometimes he doesn't want the syringe. The spreadsheet doesn't show food consumption, which is a reason it didn't make sense to me. So I assumed that food must not matter as much as I thought.We don't feed 2 hours prior shooting, for the pre-shot number is being influenced by the food and it reads higher. We test, feed and shoot [usually while their heads are in the bowl]. His "actual" pre-shot value likely have been much lower than 373, probably in the yellows [or maybe even in the blues].
I'd encourage you to stick to a consistent dose, or you'll end up in the exact same predicament where you were at the beginning.
Lantus. Likes. Consistency.
Dude needs 0.75 IU twice a day in my opinion. If you can't measure that, stick to 0.5 IU for the following 3 days. You can't keep dose-hopping, you're endangering him.
I see where it states reducing by 0.25 units but then references the FAQ & states:
Between 150 and 200 (8.3-11.1 mmol/L), you have three options:
- a.) give nothing
- b.) give a token dose (10-25% of the usual dose)
so it looks like he needed 1 unit for the PM dose
Food does matter, quite a lot. It is encouraged to feed the cat all day, or "feed the cycle" per se, so his BG stays stable or he's giving us a "flat" cycle - meaning he is in the same colour bracket throughout the entire cycle.So I assumed that food must not matter as much as I thought.
As I'm interpreting the guidelines, they indicate that I should alter the dose according to his blood glucose level. I'm confused.
If you can, today try and check Dude at +6. Tomorrow at +4. The day after +7...etc. This way the "gaps" will be filled on the sheet, thus more accurate dosing advice can be given.I'm going to try to get more readings during the day today.
The spreadsheet doesn't show food consumption, which is a reason it didn't make sense to me.
From what I read "give a token dose (10-25% of the usual dose)". "The usual dose" is that which I was adjusting down to, 1 unit, from the earlier very high dose. So 0.25 units for the PM dose, but 0.5 units was the only value I thought I could reliably dose so that's what I gave. I also didn't want to give him much (i.e. 1 unit) and have him go hypoglycemic when I was asleep so I was unsure about how much to give.I stand corrected, apologies. It's been a while since I've followed SLGS.
I don't understand your thought process, Mike. First you state you wanted to give 0.25 IU, then you state he likely have needed 1 IU. Although the latter may be the case, due to the lack of monitoring and data, we cannot be sure. It takes time to see a pattern in a spreadsheet, and some experience and knowledge to understand how depot insulins work.
E.g. you shot 1 IU on a pink yesterday AM. Nadir [the lowest point in cycle] can occur anywhere between +4 and +8 [as a rule of thumb we say usually at +6]. His PMPS likely reflects his BG curving back up already. Had you shot that number with 1 IU, in the PM cycle he could have dropped dangerously low while you're asleep. There is also an overlap between doses...
That's why it's so important to get at least one more test mid-cycle. Also, please remember, we adjust the dose based on the nadir. If you're able to get in more tests mid-cycle, you have to adhere to those rules, for the safety of your cat.
Thank you so much for your help & patience!You're doing great Mike, and learning fast! You'll have this down to a T in no time
If you need dosing advice, start a new thread under Lantus/Levemir/Biosimilars, starting with the current day's date, whether you need help with AMPS or PMPS and the value. Can pop a question mark at the front as well, so it pops out to the mods/well-known members. You'll see there how the members write their titles.
E.g.:
[?] 11/05 Dude PMPS 190 - Do I shoot?
Or 05/11, even. My mind is set to EU date format![]()
Excuse me, where is the "I can't test my cat" Michael, and what did you do to him?
I was just going to ask whether you think you could get in another test before PMPS, but I didn't want to push my luck
Will you be able to monitor the PM cycle at all? If so, give your boy a break for now [and lots of pets for being amazing with the ear pricks] and perhaps test him during the PM cycle. If you won't be able to monitor that, then a +9 before a little feed would be great. And try to not feed him after that [so after +9.5/+10 - depending how long it takes for him to eat].
I'm wondering whether your little champion will be giving us a blue as a PMPS again...
Since you've shot last night's blue with 0.5 IU and the cycle wasn't monitored/tested, we can't be sure whether he gave us a pink AMPS today because
a) the 0.5 IU wasn't enough, or
b) the 0.5 IU was too much for a blue and he dropped low and bounced back up by the morning... or
c) simply because you fed him before the AMPS test
But I'm thinking way ahead already.
Edit to add: if his PMPS is blue again, definitely post and ask for advice under Lantus, mainly because 1) more experienced members, but also 2) I probably won't be awake to see if you post under this thread.
Edit #2: if his PMPS is yellow, I think you can safely give him the 1 IU. But if you're not sure, it's always better to ask.
So it seems as if I should give more tonight
If you don't feed him during the night, this might be the case.b) the 0.5 IU was too much for a blue and he dropped low and bounced back up by the morning...