7/20 George 5th day on Lantus - PMPS 89, +1 102, +2 101, +3 96, +4 91, +5 97, +7 103

Yesterday’s post.

Today is George’s fifth day on Lantus. Still all pinks for the AMPS, but I was liking those blues last night. Not sure what happens at pm +8 that causes him to go up so much…seems like that’s when he starts coming down on the am cycle.

Do I increase by 0.25 tomorrow since no greens, or stick with the current dose for two more days since we’re seeing blues?

 

We normally hold the starting dose 7 days for the depot to build, but Wendy indicated that you could increase after 5 days in this post:
https://www.felinediabetes.com/FDMB/threads/7-18-george-amps-338-5-283.250026/

Tagging her for confirmation.
@Wendy&Neko

 

The TR protocol says to hold the initial dose 5-7 days, unless high numbers which you aren't seeing. The other exception is ketones - have you been testing for those?

If all good and you don't see greens before tomorrow, you can increase then by 0.25 units.

 

Thanks! Yes, I test for ketones weekly, and he has always been negative (last test was on the 13th, so he’s due for one today).

 

Good luck with the increase, Hilary. Those blues look really nice.

 

Thank you

 

Hm, pretty big drop between +6 and +7 (at least compared to what he’s been doing).

 

Maybe he is breaking the bounce. Keep an eye on that.

 

106 @ +9.5, maybe we’ll see some green today!

 

@Wendy&Neko Looks like George may have a low blue pre-shot today as long as he doesn’t somehow spike in this last hour and a half, so I just have two questions.

1 - If it remains low blues (aka flat from now) it’s ok to shoot, right?

2 - If he does end up seeing greens tonight, hold this dose for three more days (as long as no limes)?

 

Just seeing if there’s anyone on to confirm the questions above?

 

With the 81 at PMPS, you can stall, don't feed and test again in 20-30 minutes to see if he's still dropping

 

Thank you! I’ll retest in 20.

 

He’s at 82 twenty minutes after the last test.

 

OK...do you have plenty of supplies like test strips, high and medium carb food, Karo/honey/syrup and can you test as often as necessary tonight? (and as long as might be necessary?)

 

Yes, I have all of the supplies and will be around all night.

 

I'd go ahead with the 1.75 then and get a test at +1 and +2 so you can intervene early if you need to.

Remember, you're going to be feeding him (which should bring his BG up) and the shot doesn't usually kick in for 2-3 hours so you're actually shooting where he'll be in 2-3 hours.

 

Ok sounds good! I think I’m going to test him again in 10 minutes (so that will be another 20 total) and then I will feed/shoot and monitor for the night. Thank you!

 

Keep your subject line updated with the PMPS numbers as you get them. I'll try to keep my eyes on you but you should update your thread as you get test results until we're sure he's safe for the night

 

I ended up shooting an 89. Will check back in an hour with that +1.

 

Good deal! What you can do is put all the tests in the PMPS cell. Put 81 @+12, 89 @+12.5 ( I think we can skip trying to squeeze the 82 in). You'll have to manually color the cell yourself. By doing it like that, people can see that you stalled tonight.

And remember, the +1 is one hour since he actually got the shot, not from the usual PMPS time.

 

Alright he’s at 102 at +1. Looks like he got a food bump…he ate a hefty amount of dinner since he thought he was “starving” by having to wait a whole 40 minutes to eat.

 

Yeah, they're real good about making us feel like if they have to wait 10 more seconds, it's all over. Silly cats!

See you in an hour!

 

+2 he is at 101

 

Looking good! How about a +3 next?

 

Sounds good!

 

96 at +3

 

Nice!! Probably should get another test in an hour since he's starting to drop and he's so new to Lantus, but he's looking great!

I'm hoping @Bron and Sheba (GA) or @Wendy&Neko may be available to take over watching out for you but I'll try to be here in an hour!

 

Ok, will do, thank you so much!

 

I am around. Will just read back on the thread.
George is very handsome!

 

Thank you

 

I am very partial to ginger boys.

 

He is at 91 at +4

 

Thanks Bron! I'm running on 2 hours sleep in the last 2 days and my eyes are spinning in their sockets but I wasn't going to leave her until either somebody else took over or George was totally safe for the night!

 

Looks like he has got on his surf board and is surfing. I would give a small low carb snack and test again in 2 hours….1 hour if you feel anxious at all.

 

He is doing fantastic! That's exactly how Lantus works best....it's scary shooting those lower numbers, but usually it means there's not those sharp dives and bounces. It's just a nice (almost level) line.

I agree with Bron too! Get a nap if you can (and you'll wake up to an alarm)

 

You must be exhausted! Please go to bed!

 

You don't have to ask twice! Thanks!

You're doing fantastic Hilary and so is George! These are the kind of cycles when you can almost hear that pancreas healing!

 

I see the dose increase threat worked yet again!

 

Sounds great, thank you both!

 

I really appreciate your help and staying me! Thank you so much again!

 

I ended up getting a +5 and he’s at 97. Do you think a +7 is good for the next test?

 

I think it's safe to call it a night. He has flattened out.

 

Ok, thanks again to everyone! If he happens to wake me up in the middle of the night and I’m not too groggy I may grab another test at some point (he likes to do that more often than I would prefer haha).

 

I can see he has had a few later nadirs on the other insulin. Because you are so new to Lantus and this is the first green, I would get a +7 just to see how he goes

 

Ok, I can do that. Yeah I’m not really sure what his pattern is yet…it will be nice when I know! I’ll post an update in a couple of hours.

 

You might be able to grab a couple of hours of sleep before the test. I always slept between the tests at night, even if it was 1/2 hour. Otherwise I got too tired.

 

All is well over here. He’s at 103 at +7.

 

He's been flat as a pancake since PMPS!
Anyway, green finally!

 

Lovely cycle. He’s loving the Lantus.
I would leave a small low carb snack out for him and go to bed.