? New member, question re: shooting lower than usual PMPS

https://felinediabetes.com/FDMB/threads/new-member-first-post-its-a-long-one.235250/

Hello! I’m Terri, and this is my first time posting in the Lantus & Levemir forum. My intro post is linked above, detailing some of my sweet boy Benny’s underlying health issues. I want to thank everyone who has welcomed and encouraged us so far! Benny was diagnosed on 5/23, started on 1U Lantus 2x per day and is currently up to 5.5U. His numbers still aren’t great, but have slowly been getting a bit better. He has recently gotten over a pancreatitis flareup.

Last night his PMPS was 116, which is considerably lower than usual. I stalled 30 minutes, it dropped to 110, stalled another 30 and it dropped to 102. So I fed him and, too nervous to shoot the full 5.5U, gave him a token 1U. But I am seeing that many members are shooting their kitty’s full dose into even lower pre-shot numbers, and am wondering if I am being too cautious? I know we have to start getting him into better numbers, and don’t want my tendency to worry about those lower pre-shot numbers to be the thing that holds him back! I have supplies and am prepared to monitor, but do I have enough data? Just want to be prepared to make the best choice for Benny the next time we find ourselves in this situation. Naturally he is back up in the reds this morning, but has SO MUCH ENERGY! Running around the house, chasing his sister...for the first time in months! Will I ever understand this?! Tested for ketones (negative).

Thanks in advance

 

Hi Terri I see on your last thread @Wendy&Neko was helping you. I just tagged her for you ,sorry I can't help you
Thanks in advance Wendy

 

Thank you so much!

 

All that sugar in his system (which his body has gotten used to), no wonder he is full of energy! Over time, his body will adjust and he will feel better in lower numbers. For a long time I knew when Neko was in low 300's, cause she'd go over to her toys. I was so happy when that started happening in the low 100's.

As for shooting lower, yes absolutely that is something you can do when you have the data to do so, and ability to monitor. You got some great data last night on what happens when you skip. You can see that the insulin from the previous cycle carried on into the start of the next cycle. This is the carryover and allows Lantus to do a great job with low flat cycles. Typically, shooting lower means low but flat cycles. The danger of stalling is that their numbers can continue to drop without food. It's also good to know that the number you are shooting is a couple hours down the road, when the insulin of that cycle onsets. Food will typically take them up in that time.

A couple definitions if you aren't used to them yet:

• Carryover - insulin effects lasting past the insulin's official duration
• Overlap - the period of time when the effect of one insulin shot is diminishing and the next insulin shot is taking effect
• Insulin Depot - a "spare tank" of insulin, which has yet to be used by the body

If you read through the dosing methods sticky note, the section on SLGS and shooting lower numbers has two sections, the first for new people, and the second for when you have more data. You can start lowering the number you feel comfortable shooting the full dose, and/or that plus trying a larger token dose, maybe 1/2 dose next time. Only do this when you are around to monitor. With SLGS, you don't shoot below 90.

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@Wendy&Neko thanks Wendy

 

Haha, that makes sense! He’s on a sugar high! That is so funny you should say that about Neko, Benny is hanging out on his toys today too!

And makes sense that his numbers were continuing to drop the longer I stalled...with no food. And that the number I’m shooting is actually a couple of hours down the road. This is enormously helpful information, and I’ll remember it for next time!

Thank you for highlighting these terms, I will keep studying and trying to wrap my brain around all the nuances of how Lantus works...and for your advice regarding shooting full or 1/2 dose, depending upon his BG level (and my comfort level) when the time comes. I actually kind of hope it comes again soon! I know I have to get more comfortable with shooting these lower numbers to get him to stay lower. But I will not shoot if under 90.

Wendy, thank you so much!

 

You're welcome - you are a quick study and there is lots to learn.

 

There sure is!

 

Your kitty is adorable! I hope you start to see some better numbers soon!

Welcome to the LB&L Forum!

 

Thank you so much!! He’s such a sweetheart too We are so grateful to be here!