? 12/23 Mallie AMPS 110 no shot, +11.5 103, PMPS 104, pls look at SS-possible dosing advice?

[mom23seniors]

Mallie was 110 (6.1) this morning.
I am working today and don’t feel comfortable giving a shot since I’m not home to monitor. She did well from last night (PMPS 106) without a shot. I understand that Lantus is meant to be every 12 hours but with me not able to monitor I’m not taking any risk. Luckily I am off for the rest of the week after today so I will be able to check throughout the days.

 

[nslade001]

With that 4.5 at +5 she earned a reduction.

That being said, we don't usually take back-to-back reductions (two consecutive days) since the bg may still be influenced by the depot from the previous higher dose, so usually in this situation we'd be keeping the same dose (0.25U) today.

However, with Mallie's dosing being so inconsistent (many skipped doses and varying doses) I have no idea what her depot may be!

Before shooting again (tonight or tomorrow), I'd ask for someone to take a peek at her SS and give dosing advice (maybe she should actually be trying 0.1U twice daily at this point?) Get some experienced advice is my advice lol.

Also, I'd highly, highly recommend calipers. *Especially* if you're using BD syringes. http://www.felinediabetes.com/FDMB/threads/dosing-with-calipers-updated-w-videos.79851/

With love, Nikki

 

[Sue and Luci]

I agree with Nikki - best get some calipers as soon as you can...the next dose increment will be very difficult to measure consistently (consistently is the important word here)...you can try 'eyeballing'...but I promise you that it is just about impossible to consistently get the same small dose without calipers.

It looks like she's doing very well...and you're getting in as many tests as you can - I wondered at night if it was possible to get any other tests - yes, the alarm would need to be set to get up and test but she appears to be hitting her nadirs later in the cycle...I'm wondering if she's doing that again at night?

 

[mom23seniors]

I agree with Nikki - best get some calipers as soon as you can...the next dose increment will be very difficult to measure consistently (consistently is the important word here)...you can try 'eyeballing'...but I promise you that it is just about impossible to consistently get the same small dose without calipers.

It looks like she's doing very well...and you're getting in as many tests as you can - I wondered at night if it was possible to get any other tests - yes, the alarm would need to be set to get up and test but she appears to be hitting her nadirs later in the cycle...I'm wondering if she's doing that again at night?

Can I get the calipers from Amazon? Is it like the ones pictured?

If I am giving Mallie a shot at night, I will monitor her overnight again, to get some numbers, like I had planned to do 12/19. Ive been fighting a cold since 12/21 so I’ve been trying to sleep as much as I can since I haven’t been shooting at night. I’m a single mom so being down and out with a cold AND sleep deprived from being up in the night with Mallie is something I am trying to avoid. Like I said previously, I am off the rest of the week after today so I will be able to again, do more checking to get more numbers.

 

[Sue and Luci]

Can I get the calipers from Amazon? Is it like the ones pictured?

If I am giving Mallie a shot at night, I will monitor her overnight again, to get some numbers, like I had planned to do 12/19. Ive been fighting a cold since 12/21 so I’ve been trying to sleep as much as I can since I haven’t been shooting at night. I’m a single mom so being down and out with a cold AND sleep deprived from being up in the night with Mallie is something I am trying to avoid. Like I said previously, I am off the rest of the week after today so I will be able to again, do more checking to get more numbers.

I know that getting up at night is tough....I work full time during the day and have a mentally challenging job, so sleep loss is a critical thing for me as well...I understand...

I like these calipers https://www.harborfreight.com/hand-...rs-micrometer/4-in-digital-caliper-63710.html

They're inexpensive, but lightweight and have worked perfectly. I ordered a larger one from Amazon but never use it anymore - I keep it as a backup...just kinda too big and heavy for me.

 

[nslade001]

I picked up my digital calipers at Canadian Tire, Mastercraft brand, at 1/2 price so under $20.
I also swear by magnifying visors (got them at amazon.ca around $25) and a light box (under $15 at Walmart in the lamp department, or try the dollarstore). I got my visors with a headlamp, but don't need the lamp with the lightbox. Some use a magnifying glass but I'm not that coordinated, I need my hands for the syringe and vial lol.

 

[mom23seniors]

I just got home and tested Mallie at +11.5hrs .
She is 103 (5.7) and it’s been almost 36 hours (35 hours, 15 min) since her 0.25u yesterday morning.

I don’t have enough experience and Mallie has only been on insulin for 10 days (with skipped shots and different doses) so I’m looking for advice from people with experience.
I’m going to retest her at 6pm MST and then feed her and her brothers. Unless she jumps up to around 140 (8.0) before dinner, I’m not going to shoot tonight.

 

[Marje and Gracie]

Her numbers have been very shootable even for SLGS. I understand your hesitancy to shoot and leave for work.

With that 4.5 at +5 she earned a reduction.

That being said, we don't usually take back-to-back reductions (two consecutive days) since the bg may still be influenced by the depot from the previous higher dose, so usually in this situation we'd be keeping the same dose (0.25U) today.

However, with Mallie's dosing being so inconsistent (many skipped doses and varying doses) I have no idea what her depot may be!

Before shooting again (tonight or tomorrow), I'd ask for someone to take a peek at her SS and give dosing advice (maybe she should actually be trying

With SLGS, especially for a new member with little data, we give reductions as they are earned even if they are back-to-back. An experienced member who knows their cat well and is doing SLGS might elect to not take a back-to-back reduction but because SLGS is so conservative, I would suggest that Aly take the reduction to 0.1u as you mentioned, Nikki.

Aly...if you get a number 90 and above, and you are able and available to test, we’d like to see you start shooting. If you are unsure, then stall, don’t feed, post and let someone walk you through it. There are options but skipping shots like this is usually for the caregiver and not the cat

I would definitely reduce the dose to help you shoot every 12 hours. Hope you feel better soon!!

 

[mom23seniors]

There are options but skipping shots like this is usually for the caregiver and not the cat

Why would I shoot when she’s just barely in the blue?

Isn’t it better for her to be high-normal then down into the low-normal or lower?

of course with having dinner (and breakfast this morning) her bg is going to go up....that happens to all animals and humans....but her bg didn’t stay up high today after breakfast. She’s lower tonight at PMPS then she was at AMPS

 

[Marje and Gracie]

Why would I shoot when she’s just barely in the blue?

Isn’t it better for her to be high-normal then down into the low-normal or lower?

of course with having dinner (and breakfast this morning) her bg is going to go up....that happens to all animals and humans....but her bg didn’t stay up high today after breakfast. She’s lower tonight at PMPS then she was at AMPS

Because under SLGS, you shoot every thing above 90. You have the chance to get her into remission but unless you allow her to see some green numbers, she likely won’t stay in remission.

All we can do is advise. You hold the syringe.