BG 35 @+2. Eek/ PMPS BG HI

Jerry dutchboy

Jerry dutchboy

Member Since 2019
This morning AMPS 185 usual 2.25 IU dose. Ate well and +2 he's at 35. Freaking me out. Just gave him a large teaspoon of FF gravy.
 
Unfortunately I'm getting ready to leave. In a nutshell:
  • feed high carb gravy and retest in 15 -20 minutes.
  • go to the Lantus forum and post there for help. Make it very obvious that his BG is very low and you need assistance. Put the red 911 icon on your thread title.
  • stay on the Lantus forum. You need their expertise in helping you dose it correctly.
Good luck!
 
Kris & Teasel said:
Unfortunately I'm getting ready to leave. In a nutshell:
  • feed high carb gravy and retest in 15 -20 minutes.
  • go to the Lantus forum and post there for help. Make it very obvious that his BG is very low and you need assistance. Put the red 911 icon on your thread title.
  • stay on the Lantus forum. You need their expertise in helping you dose it correctly.
Good luck!
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Thank you.
 
You're doing the right thing by testing and feeding a small amount of High Carb. The 911 should get some attention from the experts soon. Good luck :bighug:
 
Jerry dutchboy said:
Just re-tested and he's up to Bg 49. More FF gravy going onboard.
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That is good, I think you said first time you gave a full Tablespoon of gravy, not sure how much this time, I would wait now and test again 15 minutes apart until we see what gravy is doing.

Can you stay with him for several hours today?
 
Jerry dutchboy said:
Now at 64. I'll keep an eye on it though. Makes me nervous that it's this low so early in the cycle.
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Good to hear, only problem is Lantus is long lasting, and he has the depot backup, you may need to keep an eye on him for a good part of the day, remember he still will fall again at mid cycle today.
 
Julie and Honey said:
That is good, I think you said first time you gave a full Tablespoon of gravy, not sure how much this time, I would wait now and test again 15 minutes apart until we see what gravy is doing.

Can you stay with him for several hours today?
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I gave him a heaped teaspoon first, then a smaller amount. I don't want him getting too full. I'll be hovering, not going anywhere.
 
Jerry dutchboy said:
I gave him a heaped teaspoon first, then a smaller amount. I don't want him getting too full. I'll be hovering, not going anywhere.
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Glad to hear you will stay with him. I am not an expert on dosing, but looked at Jerry’s spreadsheet and saw the last couple of days the am and pm doses were different. Not sure how that may affect things, also looks like he may need a reduction in dose, will let more experienced Lantus users respond. You are doing great, but may not be out of the woods for today yet, just keep that in mind.
 
Jerry dutchboy said:
Should i remove the 911 from this now? Don't know the protocol.
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I would leave for a little bit, he is still in a precarious situation and you need guidance. I am hoping someone with more experience will come online soon.

Once you have gotten guidance from more experienced member as to what to do, what to expect, etc, then I would take down the 911
 
Hey there! Sorry I missed the tag from yesterday's thread.

Just peeked in on your SS and saw that 35! Now that he is up over 50, test 30 minutes from the last bit of HC food. You want to make sure that he maintains over 50 and doesn't slide back down again. He hasn't hit nadir yet so it's possible. Hold the gravy unless he slides back down again. The idea is to see if he can maintain without the gravy. So, keep on testing and feeding a tsp or so of HC gravy only if needed. Good catch, Momma. How did he behave when he went that low?

Question, your SS says that last night and the night before the dose was 1.25. Was that supposed to be 2.25? He has earned an reduction down to 2 units for his PM shot. Congrats!
 
Bobbie And Bubba said:
Hey there! Sorry I missed the tag from yesterday's thread.

Just peeked in on your SS and saw that 35! Now that he is up over 50, test 30 minutes from the last bit of HC food. You want to make sure that he maintains over 50 and doesn't slide back down again. He hasn't hit nadir yet so it's possible. Hold the gravy unless he slides back down again. The idea is to see if he can maintain without the gravy. So, keep on testing and feeding a tsp or so of HC gravy only if needed. Good catch, Momma. How did he behave when he went that low?

Question, your SS says that last night and the night before the dose was 1.25. Was that supposed to be 2.25? He has earned an reduction down to 2 units for his PM shot. Congrats!
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I'm a nervous ninny do like to test at least +2. Jerry seems to have his own plan so he keeps me on edge. The 1.25 IU in the PM was on the vets advice but to keep him on 2.5IU in the AM. I'm not too sure about this plan as I know its preferable to keep the doses the same. I thought that I would follow her advice for 6 cycles and see. I don't give him 2.5 but 2.25 in the AM as he was seeing some lower BG numbers. This morning was a shock to say the least. He seemed fine, a little sleepy, but he's an older cat that sleeps a lot anyway. I will continue to monitor him today. Hope he evens out a bit. What do you guys do if the cat doesn't want to eat yhe gravy i.e. they are full? Or is that a dumb question?
 
Jerry dutchboy said:
I'm a nervous ninny do like to test at least +2. Jerry seems to have his own plan so he keeps me on edge. The 1.25 IU in the PM was on the vets advice but to keep him on 2.5IU in the AM. I'm not too sure about this plan as I know its preferable to keep the doses the same. I thought that I would follow her advice for 6 cycles and see. I don't give him 2.5 but 2.25 in the AM as he was seeing some lower BG numbers. This morning was a shock to say the least. He seemed fine, a little sleepy, but he's an older cat that sleeps a lot anyway. I will continue to monitor him today. Hope he evens out a bit. What do you guys do if the cat doesn't want to eat yhe gravy i.e. they are full? Or is that a dumb question?
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The kitty getting too full and not wanting to eat while steering lower numbers can be problematic. The best thing to do is small amounts at a time, a tsp or so. It can mixed with a little lower carb food as the HC gravy wears off fast and the lower carb will hang out with them longer. Not a dumb question at all. If all else fails and they won't eat, you can rub a little honey or syrup on their gums to boost them up. While he's up over 50, I wouldn't feed again for just that reason that the kitty can get too full and won't eat when you really need to boost up. And you want to see if he will drop again or just surf.

As far as your vet's RX of doing different dose AM /PM, it is not good advice . Lantus needs consistent dosing every 12 hours for the depot to get stable or how will you know what dose Jerry is reacting too? Plus, you gave him lower doses those two nights when he was at his highest and could have used the 2.25 dose.

If he were my kitty, I would reduce the dose to 2 units tonight and hold that dose for 6 cycles which is how long it takes a dose to show what it will do. You test enough to catch any lows and if you follow the protocol ( not sure whether you are doing TR or SLGS) you will know where his dose really is without interruption of moving it around.

Keep on testing him until he is out of the woods. He is likely to bounce up higher later today or tonight from being in lower numbers than he is used to being in. Also, that was a big drop from you AMPS to the +2 and kitties will bounce just as much from a fast drop as they will from lower numbers.
 
Bobbie And Bubba said:
The kitty getting too full and not wanting to eat while steering lower numbers can be problematic. The best thing to do is small amounts at a time, a tsp or so. It can mixed with a little lower carb food as the HC gravy wears off fast and the lower carb will hang out with them longer. Not a dumb question at all. If all else fails and they won't eat, you can rub a little honey or syrup on their gums to boost them up. While he's up over 50, I wouldn't feed again for just that reason that the kitty can get too full and won't eat when you really need to boost up. And you want to see if he will drop again or just surf.

As far as your vet's RX of doing different dose AM /PM, it is not good advice . Lantus needs consistent dosing every 12 hours for the depot to get stable or how will you know what dose Jerry is reacting too? Plus, you gave him lower doses those two nights when he was at his highest and could have used the 2.25 dose.

If he were my kitty, I would reduce the dose to 2 units tonight and hold that dose for 6 cycles which is how long it takes a dose to show what it will do. You test enough to catch any lows and if you follow the protocol ( not sure whether you are doing TR or SLGS) you will know where his dose really is without interruption of moving it around.

Keep on testing him until he is out of the woods. He is likely to bounce up higher later today or tonight from being in lower numbers than he is used to being in. Also, that was a big drop from you AMPS to the +2 and kitties will bounce just as much from a fast drop as they will from lower numbers.
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So you think i should go from the 1.25 Pm dose to 2IU for the PM cycle?
 
Bobbie And Bubba said:
Yes, as long as he comes up to a number you can shoot. Let's see where he is at +11 and if you could post for dosing advice then if you aren't sure whether or not to shoot.
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Absolutely...i was going to ask this question about shooting this PM but figured it was too early and I should wait and see. Just did.another test and he's holding at 56. I'll do another test at +5 and update his ss.
 
Bobbie And Bubba said:
Is this holding without food?
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Yes he is. Just tested him and he's at 65. Hoping we're on a bit of an upswing. I'll be testing pretty much every half hour until his numbers get up there a bit and then switch to hourly to give his little ears a break. I'm so luckly that he is very laid back about testing, he doesn't seem to mind in the slightest. Thank you for hanging in it means a lot to me.
 
I had it on a 911 for a while but we seem to be out of the danger zone right now. If I think its going wrong I'll change it again.

How do I know that someone is experienced?
 
Bobbie (Bobbie & Bubba) is very experienced and you are in good hands. I too have been silently peaking in to see how things are going and I wouldn't be surprised if others haven't been doing so as well. Sometimes it's better not to have multiple hands in the pot and things are going fine at this point in time. 911 is not needed as long as Jerry continues to surf in those lovely greens. :)
 
MrWorfMen's Mom said:
Bobbie (Bobbie & Bubba) is very experienced and you are in good hands. I too have been silently peaking in to see how things are going and I wouldn't be surprised if others haven't been doing so as well. Sometimes it's better not to have multiple hands in the pot and things are going fine at this point in time. 911 is not needed as long as Jerry continues to surf in those lovely greens. :)
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Yes great hands, I've been peaking myself
 
Thanks. I would like it better if he was in the blue but at least its a long way from the 35 i had this morning. I wasn't sure about the 911 as I don't want to cry wolf if you know what I mean. I really do appreciate everyone taking the time to watch and advise. Jerry (who btw seems totally unphased by all of this) is grateful as well. :)
 
Lime green numbers always get the adrenal going and so do nice dark green numbers when they don't happen often or haven't for awhile. I remember my first and running around my coffee table talking myself through hypo instructions. If any one had seen me, they would have locked me up! :woot: It gets easier with experience like anything else. Today's cycle is now beautiful but it is likely Jerry will bounce some after this so don't be disappointed if his numbers when they start going up, go up higher than you'd like. This too shall pass. ;)
 
MrWorfMen's Mom said:
Lime green numbers always get the adrenal going and so do nice dark green numbers when they don't happen often or haven't for awhile. I remember my first and running around my coffee table talking myself through hypo instructions. If any one had seen me, they would have locked me up! :woot: It gets easier with experience like anything else. Today's cycle is now beautiful but it is likely Jerry will bounce some after this so don't be disappointed if his numbers when they start going up, go up higher than you'd like. This too shall pass. ;)
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I know that feeling all too well. That's why this forum is fantastic, it really helps me stay focused and not to get too panicked. Still had that knot in my stomach though. Jerry didn't have any symptoms I DID...ha ha.
 
Squeaky and KT (GA) said:
Good job Deirdre! I've been popping in and out - you were already in good hands by the time I arrived so didn't post while the situation was happening. Now that you're back in safe territory, sending a 'Good job' and BIG hug!
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Aaaw thank you. Praise from all of you makes it all better. So nice of you all to help me out like you have. I am so grateful to have found this site. I gave the site info to my vet so she can pass it on to other FD momma and papa newbies.
 
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Good job today! Time for a Momma treat.....a little chocolate or some wine (it's 5pm somewhere!;))!

I suggest you reduce the dose down to 1.75u tonight. Jerry earned a couple of reductions (readings below 90) on Mar 30th and 31st that you didn't take. With the lowered doses the last couple of nights it's hard to say where Jerry's depot is and he may be a bit more sensitive to insulin after that low this morning so be sure to get that +2 again tonight. I agree with Bobbie that you need to find a consistent dose that you can give both AM and PM to determine exactly how the dose is working for Jerry. :)
 
MrWorfMen's Mom said:
Good job today! Time for a Momma treat.....a little chocolate or some wine (it's 5pm somewhere!;))!

I suggest you reduce the dose down to 1.75u tonight. Jerry earned a couple of reductions (readings below 90) on Mar 30th and 31st that you didn't take. With the lowered doses the last couple of nights it's hard to say where Jerry's depot is and he may be a bit more sensitive to insulin after that low this morning so be sure to get that +2 again tonight. I agree with Bobbie that you need to find a consistent dose that you can give both AM and PM to determine exactly how the dose is working for Jerry. :)
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Well he is now HI on the Relion Prime. I knew that he would jump up but I never thought this high this quickly. But then again I didn't think he would drop that fast either. Anyways, I will give him a 1.75 IU dose for his PM and monitor him again.
I understand what you guys are saying about consistent dosing and agree. I did sort of argue with the Vet but she persisted and so I caved and thought since he had been running low in the PM cycle is couldn't do any harm but I think I will return to equal doses going forward. What do you think about in the morning? Should I also stay at the 1.75IU???
 
I would stick with the 1.75u twice daily for a week provided he doesn't go below 90. If he goes below 90, then he earns a 0.25u reduction immediately.

From the SLGS documentation.......
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. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • 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
 
Ok thanks. Think i've got it this time.

I always hate to go against Vet's instructions and I didn't like her idea in the first place but I'm still learning and deferred to her. By the time i pay her a visit next time I'll have better information to argue the point.
 
Given the way your vet is suggesting you dose, it seems she is still thinking in terms of other "in and out" insulins that are commonly used for diabetic pets. It's possible to use a different dose AM vs. PM with specific veterinary insulin and some human insulins but it doesn't work well with Lantus and definitely not using the dosing methods we use here.
You just need to show her that 35 you got this morning to prove the dose had to be reduced and when Jerry's numbers have improved, the vet won't be able to argue with success. ;)
 
So +11 is 525. I'll obviously get another BG for the PMPS. I will shoot 1.75 as you suggest. I'm not sure how to tag someone but Bobbie and Bubba asked me to post the number. Can you help me with that?
 
Yes, I'll be around. You just need to edit your title. Add PMPS and the # after what's there already. To edit the title, look up in the upper right area of your screen. There is a little tab that says Tools. Click on that and it will give you the option to edit the title. Then the title box will open and you can add your PMPS #. Any problem, let us know. Don't think you need the "?" mark prefix any more either.

Glad to see the BG has come down a tad.
 
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