PMPS 167 to shoot or not shoot?

Discussion in 'Lantus / Levemir / Biosimilars' started by Jessica & furbaby Indie, Sep 12, 2016.

Thread Status:
Not open for further replies.
  1. Jessica & furbaby Indie

    Jessica & furbaby Indie Member

    Joined:
    Aug 11, 2016
    Am doing SLGS method. So I know I have three options. Last time she was 160's pre shot I skipped her dose. But tomorrow night I am skipping her dose already because of a work event and want to keep her regulated so am tempted to give her a token shot. Thoughts?

    She is at 3 units today 2x a day just started. I messed up and skipped over the 2.75 dose. Vet recommended weeks ago I go straight to 3 units 2x a day and I held off and went slow. But her numbers continued to be high so I went from 2.5 to 3 units 2x a day just this wknd. Is hard measuring the 2.75 out! So end up getting close to 3 anyways.

    Also should mention she had diarrhea yesterday and started her on Slippery Elm Bark.
     
  2. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    You don't have enough tests for me to advise you. Is it possible to get some +2-3 or before bed tests? We dose based on the lowest point in the cycle, the nadir. With a .5 increase she might go low tonight even if you shoot a reduced dose as the depot has begun to fill. See what others say. I'll tag a few people. Are you stalling and not feeding? What time do you shoot?

    @Chris & China @julie & punkin (ga) @Sienne and Gabby (GA)
     
  3. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

    Joined:
    Feb 17, 2011
    Let me look at the spreadsheet - I'll be right back.
     
  4. Jessica & furbaby Indie

    Jessica & furbaby Indie Member

    Joined:
    Aug 11, 2016
    I usually shoot at 7:30pm. I just decided to skip her shot. Have a huge meeting at work tomorrow and don't want to risk her going low tonight. Poor baby. She is being so vocal. I just feel like she is uncomfortable.

    Just tested her BG and it was 195 at +2.
     
  5. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

    Joined:
    Feb 17, 2011
    I'd move the dose back to 2.75u. It probably seems like that tiny bit wouldn't make a difference but it can. In your last curve on the 10th, you did a great job of getting the nadirs (low points) and we can see that the 2.5u could get her to about 155. Comparing that nadir to the SLGS guidelines below, you would increase the dose by 0.25u.

    After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours:
    Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet.
    • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
    • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
    • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
    As far as shooting tonight, here are your 3 choices:

    • 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); c.) feed as usual, test in a couple of hours, and make a decision based on that value.
    Eventually you want to work up (down) to shooting lower numbers. Experienced people following SLGS will try to get to the point of shooting as low as 90. In your case, I'd ask if you are able to monitor tonight. Can you test more this evening? If not, then the token dose would probably be the best option.

    Is she eating normally tonight?
     
  6. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

    Joined:
    Feb 17, 2011
    ok, just saw your last post. That'll let you get a good night's sleep tonight.

    Another time, when you are able to monitor, it would be a good opportunity to try shooting say, over 130 or something. Just gradually move down your no-shoot number - but only when you can monitor. That's a great way to get control of her blood sugar and lower her overall range.

    It is important, though, not to shoot lower numbers if you can't monitor in the beginning, to make sure you keep her safe.

    Good luck with your work.
     
  7. Jessica & furbaby Indie

    Jessica & furbaby Indie Member

    Joined:
    Aug 11, 2016
    Yes she ate almost 1/2 a can of her Purina DM this evening.

    She just is so different. Very vocal. Loose stools. Very aggressive towards her sister. Am trying to baby her and cuddle with her now.

    Okay, I will go back to trying to shoot the 2.75. I get ao worried because the vet told me 3 units and I am completely disobeying him! I did this with my hyperT cat before she was treated when I was still giving her medicine. The vet told me a much higher dose than the board I was on said to do and my vet was furious! Its almost humorous now. But wasn't at the time. And Indie sees the vet Friday! So I wanted to have her at the prescribed dose by then but guess I better stick with my gut and my plan and keep going slow.

    Thanks for reassuring me.
     
  8. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

    Joined:
    Feb 17, 2011
    Just saying, there's no reason you need to give your vet the spreadsheet if it's going to cause friction . . .
     
  9. Jessica & furbaby Indie

    Jessica & furbaby Indie Member

    Joined:
    Aug 11, 2016
    Haha yeah I don't think I will be!
     
  10. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    A lot of cats here don't even go to the vet for anything to do with their diabetes anymore....the people here know so much more than the vast majority of vets do!

    My own cat hasn't been to the vet for her diabetes since I first got her script for Lantus....since then, she's never been to the vet for anything having to do with her diabetes. When she's had to go for other things, I've just said "she's on X units of Lantus and her blood glucose usually runs between X and Y" and that's pretty much the end of the discussion....If the vet does feel like she has to say something, I just nod my head, smile and say something like "that's something to think about" and then go home and continue to do what works for her!
     
Thread Status:
Not open for further replies.

Share This Page