Zoot! Can anyone tell me the BG number when not to shoot Lantus?

Discussion in 'Lantus / Levemir / Biosimilars' started by Cinnie Cole, Dec 15, 2019.

  1. Cinnie Cole

    Cinnie Cole Member

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    Jun 1, 2019
    He is at 190, and I cannot find the document that says stuff about when not to shoot. Thanks
     
  2. Sandra And Buddy (GA)

    Sandra And Buddy (GA) Well-Known Member

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    Oct 4, 2019
    Typically the no shoot number is 50 on a human meter, and if you have enough data to know how he will react.
     
  3. Sandra And Buddy (GA)

    Sandra And Buddy (GA) Well-Known Member

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    Oct 4, 2019
    From the sticky
    http://www.felinediabetes.com/FDMB/...y-to-shoot-handle-lower-pre-shot-numbers.147/


    How to Deal with Low Preshot Numbers (the following guidelines apply to those following the Tight Regulation Protocol only):
    You just tested your cat’s preshot number, and there is a much lower than usual number staring back at you. What do you do?

    There is no one-size-fits all answer, but there are some general guidelines. As with everything else, each cat is different (ECID) and each caregiver is different too.

    The short answer is that most kitties can be shot at +12, almost regardless of the number, once you are data ready to do so. The exception is that shooting 30s or 40s is not recommended for most cats, so if a cat is lower then usually the best option is to wait until they are at a shootable number to shoot. What constitutes a shootable number will vary by cat, but we don't suggest or recommend shooting a preshot number less than 50. While you’re waiting, the depot is draining, so you want to get the insulin in as soon as it makes sense to shoot.

    If it is your first time shooting green, then we will likely suggest that you stall the first time, even if the number is 80-100. That will let you collect data on what your cat will do when you stall. One thing you can do if you are having a low cycle is to get a +10 and +11. Those will give you a good idea of how quickly the cat’s numbers are rising (or not) when preshot time arrives.

    Beyond the general guidelines, there are other factors we consider when we are helping someone with a low preshot.
    • If the low preshot is not part of that cat’s normal pattern or there is reason to think something might be wrong, we will be more conservative.
    • If the cat is not a food spiker or tends to have an early onset/early nadir then they may not want to shoot as low. If the cat has a late nadir, then they will HAVE to learn to shoot low.
    • We will also be more conservative in some cases because of the person – if you are not able to monitor then you want to be more careful, or if you are not sure that you can get back to the board to keep us updated throughout the cycle. Trust me, if you shoot low, we will be watching for your updates and we will worry if we don’t see them.
    • We have to be a lot more careful with the cats who eat only dry food, because they don’t have access to the tools the rest of us use to keep our cats safe.
    • Also, when it comes to very low preshots, there is an unwritten rule that whoever helps that person shoot low should expect to sit with them through any low parts of the cycle. There have been times when I knew a cat’s number was likely shootable, but I also knew that I could not be around to help if the shot resulted in low numbers later in the cycle. For safety’s sake, if I could not find someone else who would be available to support for the next several hours, I would most likely suggest that the shot be reduced or skipped. I will not encourage someone to shoot low and then abandon them.
    • There are a lot of other scenarios, and you always want to keep your cat in mind.
     
  4. Cinnie Cole

    Cinnie Cole Member

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    Jun 1, 2019
    I thought that it was much higher - 150 or 200 - now I am just confused.
     
  5. Sandra And Buddy (GA)

    Sandra And Buddy (GA) Well-Known Member

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    Oct 4, 2019
    I just noticed you dont have which protocol you are following in your signature, Are you doing TR or SLGS?
     
  6. Crista & Ming

    Crista & Ming Well-Known Member

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    Jun 10, 2018
    What @Sandra And Buddy said about not shooting under 50 is if you choose to follow Tight Regulation (TR) and if you have enough data to feel comfortable shooting lower numbers.

    You have shot lower in the past and Zoot is coming up.

    But here are the general guidelines for those new to lower PS numbers:

    I'm not familiar with Zoot. Are you following a method? It seems like you're following SLGS though. Good numbers for Zoot today!
     
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  7. Crista & Ming

    Crista & Ming Well-Known Member

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    Jun 10, 2018
    I read your SS notes just now. Seems like you're working with the vet and switching to AlphaTrak. Are you still using the Relion right now?
     
  8. Cinnie Cole

    Cinnie Cole Member

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    Jun 1, 2019
    Okay - so I feel like it was safe to give his dose at 190. We checked him right before dosing and he was 297 - that was within an hour. It could be he is bouncing due to the low numbers/increased dosage. We are thinking best to monitor him, test tonight and be consistent. In any case we dosed him as normal.
     
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  9. Cinnie Cole

    Cinnie Cole Member

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    Jun 1, 2019
    Oh crap- well we dosed him a full dose, but I will say that he was 297 right before dosing, so maybe we are okay. I will check him at +1 and +2 to see how he is doing.
     
    Sandra And Buddy (GA) likes this.
  10. Cinnie Cole

    Cinnie Cole Member

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    Jun 1, 2019
    Long story but we just changed vets because we could not get on the same page with our prior vet. We have yet to figure out which protocol we will follow.
     
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  11. Cinnie Cole

    Cinnie Cole Member

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    Jun 1, 2019
    Yes still using the ReLion micro.
     
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  12. Sandra And Buddy (GA)

    Sandra And Buddy (GA) Well-Known Member

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    Oct 4, 2019
    Thanks for jumping in, That was the only info I knew where to find. I do need to work on my "helping skills" :)
     
  13. Cinnie Cole

    Cinnie Cole Member

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    Jun 1, 2019
    Thanks to all for all the help. Zoot does generally have good numbers even at higher numbers, but having low numbers is, frankly, scary, because he has been in yellow and pink for so long!
     
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  14. Crista & Ming

    Crista & Ming Well-Known Member

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    Jun 10, 2018
    I would've advised you to give the full dose anyway :) Good job! Zoot may be bouncing from the nice green he saw today.

    I'm not saying don't work with your vet, but many of us go to our vets for all things unrelated to diabetes. It's difficult to juggle vet advice with the advice here as they're not often seen eye to eye. In the end, it is your choice and it's up to you what you're comfortable doing for Zoot.

    But I always vote to follow those here at FDMB. Many of us live and breathe diabetes and the collective knowledge gathered here has been so valuable to me -- even life saving. While vets only have the opportunity to see a snapshot of the lives of a diabetic cat and the caregiver. We don't do things "just because" but follow protocols (The TR protocol is published in a journal of veterinary medicine) so everything here is done safely and methodically. I encourage you to take a peek at other people's threads and see what's going on around the Lantus board. You'll learn lots :D
     
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  15. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    I want to tweek some of the information. The issue of a "don't shoot' number isn't entirely accurate. With someone who is new to FD, we suggest that if you're following TR, to post and ask for help if numbers are at 150 or less. With SLGS, you post and ask for help if numbers are 200 or below. As there are several options available, someone who had dealt with this situation can walk you through the possibilities and help you figure out what is best given the current situation.

    When you do not shoot is if numbers are below the dose reduction threshold. You don't shoot below 50 with TR or 90 with SLGS.
     
    Last edited: Dec 15, 2019
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  16. Cinnie Cole

    Cinnie Cole Member

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    Jun 1, 2019
    Thanks. We still need to figure out TR versus SLGS or if we want to rely on our Vet. Right now in our household we are struggling with this decision. I should have just enjoyed the day of blue and green instead of freaking out.
     
  17. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    If it's any consolation, everyone wants their cat in good numbers and pretty much everyone freaks out when it happens. You're in good company!
     

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