Dosing Advice Needed asap please!

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Diane Engoron

Diane Engoron

Member Since 2020
Wenchie had a really good day. Her BG tonight was 199. I have been giving her .25 units of Lantus twice a day. Should I give her the .25 tonight or a little less? I'm so terrified of her crashing on us! Thank you!
 
Hi Sorry I can't help you on dosing but just looked at your spreadsheet if possible could you please fill in the test from the 18th, 19th, both am and pm and this morning , members might want to see how she did on the 0.25 dose, I'm sure/someone will come along soon
 
Diane Tyler's Mom said:
Hi Sorry I can't help you on dosing but just looked at your spreadsheet if possible could you please fill in the test from the 18th, 19th, both am and pm and this morning , members might want to see how she did on the 0.25 dose, I'm sure/someone will come along soon
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Hi there! Thank you but it is filled in!
 
As it's been a little bit, could you test again now?

That would be helpful for a more advanced person to know.

And are you following start low go slow?

Although it looks like you just gave a shaved dose per your spreadsheet?
 
Diane Engoron said:
I have no idea what a pre-shot is! I test her, feed then shoot then repeat 12 hours later unless we're doing a curve. Sorry, I'm very new at this!
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OK no problem the pre shot is when you test her first thing in the morning and then 12 hours later when you test her at night

After that you should be testing Wenchie a few times after that to see how the insulin is affecting her, just like you did on the 17th

You don't have to do another curve every time
In the morning you can test maybe 2 or 3 hours after you give the insulin
Then again let's say at the 6th hour and so on to make sure she is not dropping too low so you know to feed something

Same thing with testing at night
 
toomanycats said:
As it's been a little bit, could you test again now?

That would be helpful for a more advanced person to know.

And are you following start low go slow?

Although it looks like you just gave a shaved dose per your spreadsheet?
Click to expand...

I am not understanding why I have to test her again. I test in the morning, feed then shoot, repeat 12 hours later unless we're doing a curve.

Yes, doing SLGS. I had to give her something because of the timing so, yes, a shaved dose. A tiny bit less.
 
OK no problem the pre shot is when you test her first thing in the morning and then 12 hours later when you test her at night

After that you should be testing Wenchie a few times after that to see how the insulin is affecting her, just like you did on the 17th

You don't have to do another curve every time
In the morning you can test maybe 2 or 3 hours after you give the insulin
Then again let's say at the 6th hour and so on to make sure she is not dropping too low so you know to feed something

Same thing with testing at night.
You should be testing her through the day because god forbid she drops low like she did on the 17th , it was 35 at one poibt , you can feed her to bring her BG up, , its very important , you wouldn't want to wait until she showed signs of being very lethargic and possibly worse than that if you are not around
 
So, when you get a lower than expected number at that 12-hour mark, it can be helpful to not feed yet and to do another test 15 minutes later so you can see if that number is increasing on its own - it lets you know a little more info about what's going on. If the number is rising on its own without food, that means it's safer to shoot vs. if the number is still going down. The more data we have about what's going on between those shots, the more confidence we'll have in giving advice about to handle the number you are seeing.

It's frustrating, I know - I had to test Buzzy 4 times last night in the span of 40 minutes before I made a shoot decision.

I wouldn't panic about tonight's dose - you've given her 0.25 before with a number lower than this, but we don't have data to see what doing that really did other than that her number was high the next AM.
I would suggest testing again tonight to see where that number is going (A more advanced person than me may have more specific advice than this regarding when to test).

Have you read some of the stickies in the Lantus-specific forum?

Dosing Methods sticky

New to the Group Start Here sticky
 
Diane Tyler's Mom said:
OK no problem the pre shot is when you test her first thing in the morning and then 12 hours later when you test her at night

After that you should be testing Wenchie a few times after that to see how the insulin is affecting her, just like you did on the 17th

You don't have to do another curve every time
In the morning you can test maybe 2 or 3 hours after you give the insulin
Then again let's say at the 6th hour and so on to make sure she is not dropping too low so you know to feed something

Same thing with testing at night
Click to expand...

She free feeds all day long - always has - she had her shaved dose at about 6:15 - how long should I wait to retest?

She is still eating as I type this - has always been a very s-l-o-w eater!
 
Right, as Diane said - see how when you did her curve she started super high but then a few hours later she was in the 30s, which is a dangerous number & requires some quick action. That's the kind of thing we try to catch by grabbing a test or two between AM and PM tests and doses.
 
Diane Engoron said:
She free feeds all day long - always has - she had her shaved dose at about 6:15 - how long should I wait to retest?

She is still eating as I type this - has always been a very s-l-o-w eater!
Click to expand...
You don't have to do another curve every time
In the morning you can test maybe 2 or 3 hours after you give the insulin
Then again let's say at the 6th hour and so on to make sure she is not dropping too low so you know to feed something

Same thing with testing at night.
You should be testing her through the day because god forbid she drops low like she did on the 17th , it was 35 at one point, , you can feed her to bring her BG up, , its very important , you wouldn't want to wait until she showed signs of being very lethargic and possibly worse than that if you are not around

Take a look at my spreadsheet and you will get an idea about testing different times through the day and night
 
I believe the general guidance is "when you shoot a new low, you want to get at least a +1 and a +2" -- the +1 will ideally be higher than the pre-shot test, and the +2 will ideally be not a ton lower than the pre-shot test.

Given her plummet at +4 in that curve, I would also grab that or a +3...or both...I know it's a lot of testing, and a more advanced person may totally say I'm being unreasonable -- I can only tell you that what I would do is, at a minimum, grab a +1, +2, And I'd probably aim for +3 or +3.5 given that the only data point we have is that +4 was dangerous the last time she dropped so you'd want to catch it as soon as possible
 
Also her nadir (lowest point) looked to be around +6 in your one curve, but you could see it coming at +4 -- see this is kind of how you look at the data...I'm rambling here.

Do you have plenty of test strips? honey/karo/pancake syrup? High-carb/medium-carb food? Because, if not, I would definitely be sending someone to get those things now.
 
Also - sorry for being overwhelming - I'm sure I am being. I am new at this myself, so I am not the calm, steady presence of all the folks I tagged :)
FWIW though I would likely have made the exact same decision that you did to give a shaved dose. It's just important to grab some extra data now to see what it's doing so that, next time, you have even more information to build up your confidence. 199 is a totally shootable number.
 
toomanycats said:
Also her nadir (lowest point) looked to be around +6 in your one curve, but you could see it coming at +4 -- see this is kind of how you look at the data...I'm rambling here.

Do you have plenty of test strips? honey/karo/pancake syrup? High-carb/medium-carb food? Because, if not, I would definitely be sending someone to get those things now.
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Yes, I have all those things. I am so not understanding any of this. I go to bed at 8pm so I'm exhausted right now. I'm up at 4am every day. I cannot stay up to 9, 10 and on. This is going to put me in an early grave. Honestly - that's how I'm beginning to feel.

Now I totally understand why people with diabetic cats put them down or drop them at shelters. My whole life revolves around my animals but my others are basically just being fed and watered because we are totally focused on Wenchie. Everything else has fallen to the wayside - my house, my husband, my other animals, and my health. I'm so frustrated.
 
You don't have to test all the time...just always the Pre-shot tests and then get tests in between the shots as you can

The .25 would have been fine. We don't even suggest "stalling" unless they're below 150 but it's fine that you shot a little smaller dose.

It's all overwhelming at first, but really, once you start to understand how the insulin works in your cat and get your routine down, it's not much more disruptive than brushing your teeth twice a day with an occasional floss in between.

I like to compare the spreadsheet to a puzzle. If the only pieces you have filled in are along the edges (Just the Pre-shot tests), it's impossible to know what the picture is. If you sprinkle pieces all over, the picture becomes clearer
 
Chris & China (GA) said:
You don't have to test all the time...just always the Pre-shot tests and then get tests in between the shots as you can

The .25 would have been fine. We don't even suggest "stalling" unless they're below 150 but it's fine that you shot a little smaller dose.

It's all overwhelming at first, but really, once you start to understand how the insulin works in your cat and get your routine down, it's not much more disruptive than brushing your teeth twice a day with an occasional floss in between.

I like to compare the spreadsheet to a puzzle. If the only pieces you have filled in are along the edges (Just the Pre-shot tests), it's impossible to know what the picture is. If you sprinkle pieces all over, the picture becomes clearer
Click to expand...
Thanks Chris, I tried to explain the best I could, I saw that you had spoken to her before that's why I tagged you, thank you very much
 
Chris & China (GA) said:
You don't have to test all the time...just always the Pre-shot tests and then get tests in between the shots as you can

The .25 would have been fine. We don't even suggest "stalling" unless they're below 150 but it's fine that you shot a little smaller dose.

It's all overwhelming at first, but really, once you start to understand how the insulin works in your cat and get your routine down, it's not much more disruptive than brushing your teeth twice a day with an occasional floss in between.

I like to compare the spreadsheet to a puzzle. If the only pieces you have filled in are along the edges (Just the Pre-shot tests), it's impossible to know what the picture is. If you sprinkle pieces all over, the picture becomes clearer
Click to expand...

OK - just walked away, took a deep breath, and found Wenchie sitting on my recliner on my blanket - just like she used to do in the old days. That made me smile.

I'm sorry - it's all so frustrating and I'm not at my best this late at night. She looks fine, actually really good, better than she has since this all started. I am planning on testing her at 8:15 then going to bed. That would be +2 after her PMPS. My husband says I'm freaking out over nothing. I don't even know anymore!
 
Diane Tyler's Mom said:
I tried to explain the best I could,
Click to expand...

You did good! It actually helps to have more than one person explaining things because each person will say the same thing in a different way....and that "different" way may be the one the person needed to hear to get the light bulb to go off!

Everybody understands things in their own way, so it's good to have things explained differently!
 
toomanycats said:
See - it's not nearly as serious as I made it out to be ;)
I've still just got the newbie jitters. Sorry for passing my anxieties along!
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Oh man, yes, newbie jitters. No problem. I'm tired, anxious, nervous - all of those things - I love this girl so much and I don't want my insanity to wash over her.

I appreciate every single word you responded. Honestly, I do. I just need to breathe and go to bed in an hour or so. It will all be OK in the morning!
 
Diane Engoron said:
I am planning on testing her at 8:15 then going to bed. That would be +2 after her PMPS.
Click to expand...

That would be perfect! I've found that the +2 was like an "early warning" for most cats!

If the +2 is about the same as the PS, it's usually a pretty normal cycle...gradually down to nadir and then gradually back up again

If the +2 is higher than the PS, that usually signals a bounce, and those are the cycles when you can usually take a pokey break.

If the +2 is lower than the PS, that's your "Early warning" that kitty might be going much lower later in the cycle so it's important to plan on getting another test or two (or 6) in.

Don't worry! We all feel like you do at some point....but it will get easier, I promise!
 
toomanycats said:
@Diane Engoron literally you sound EXACTLY like me last week. I also am up at 4-something every day, am pregnant, and can't stay up. I 100% promise it gets easier. When you have more data, the decision become much easier to make. You're in the thick of it right now -- the hardest part
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This will make sense when you get to the end - Christmas 2018 a close friend was diagnosed with breast cancer and she was reeling! I took over - I went to all her appointments, took massive notes and then transcribed them and put them in folders, handled all the correspondence to friends and family so she didn't have to, keeping them updated, was with her, her mom and daughters the day of her surgery and there when we got the good news that she was 100% in the clear. Never.....freaked.....out for one moment. And she is a close friend, I love her like a sister.

But when my animals get sick, I feel lost. I don't want them to feel poorly one moment in their lives. And this is what I'm feeling right now. I can't fix this quick enough to make her feel better.

Sigh.....
 
Chris & China (GA) said:
You don't have to test all the time...just always the Pre-shot tests and then get tests in between the shots as you can

The .25 would have been fine. We don't even suggest "stalling" unless they're below 150 but it's fine that you shot a little smaller dose.

It's all overwhelming at first, but really, once you start to understand how the insulin works in your cat and get your routine down, it's not much more disruptive than brushing your teeth twice a day with an occasional floss in between.

I like to compare the spreadsheet to a puzzle. If the only pieces you have filled in are along the edges (Just the Pre-shot tests), it's impossible to know what the picture is. If you sprinkle pieces all over, the picture becomes clearer
Click to expand...

Gotcha, Chris - and thank you for your patience with me. I look at her and am always on the verge of tears. Here's this gorgeous 14 pound Maine Coon (never heavy, just a gentle giant) who is now 6 pounds and it breaks my heart every time I touch her. And I know me freaking out doesn't help the situation. A good night's sleep and I'll be up and at 'em at 4 am!

Thank you.
 
Even though you are using the SLGS protocol, you need some mid-cycle test data to see how far the blood glucose level drops on the dose of insulin you are currently giving your cat. It's not the pre-shot tests that you base the dose changes on. It's the tests in the middle of the cycle that are used to know when or if the dose needs to be increased or decreased.

Once you have that data, the decision on what to do with the dose becomes easier. Not simple, but easier.

You did a curve back on 2//17/2020 but then you ended up skipping the dose a couple of times, reducing the dose and getting some really low pre-shot tests. (test you do before you give the insulin). With those skipped shots, and the lower dose, the insulin "depot" or storage area has been draining.

So with only the pre-shot tests, there is no way to tell how the current 0.25U dose is affecting Wenchie.

That is why people are suggesting you get some more tests during this PMPS dosing cycle. Like Chris said, the +2 can give you a good idea of what direction the blood glucose level is headed for the rest of the cycle.
 
Haha thanks - pregnant with my second - thank god for my husband picking up my slack with our 3-year-old right now. Honestly this whole process reminds me of when she was a newborn lol.

I will say though I totally get wanting to fix it I am a fixer myself and I wanted to fix this like within days and was super jealous of the people whose cats went into remission as soon as they change their food... but the truth is that they start feeling better long before they go into any sort of remission and honestly they can even start feeling better before they really stabilize. You don’t have to totally fix it (not that we have any control over that anyways) to make it better. <3
 
Deb & Wink said:
Even though you are using the SLGS protocol, you need some mid-cycle test data to see how far the blood glucose level drops on the dose of insulin you are currently giving your cat. It's not the pre-shot tests that you base the dose changes on. It's the tests in the middle of the cycle that are used to know when or if the dose needs to be increased or decreased.

Once you have that data, the decision on what to do with the dose becomes easier. Not simple, but easier.

You did a curve back on 2//17/2020 but then you ended up skipping the dose a couple of times, reducing the dose and getting some really low pre-shot tests. (test you do before you give the insulin). With those skipped shots, and the lower dose, the insulin "depot" or storage area has been draining.

So with only the pre-shot tests, there is no way to tell how the current 0.25U dose is affecting Wenchie.

That is why people are suggesting you get some more tests during this PMPS dosing cycle. Like Chris said, the +2 can give you a good idea of what direction the blood glucose level is headed for the rest of the cycle.
Click to expand...

OK. Got it! Thankfully, my husband stays up later. I will test her at +2 and then go to bed. But he will keep an eye on her and wake me if necessary.
 
Chris & China (GA) said:
You did good! It actually helps to have more than one person explaining things because each person will say the same thing in a different way....and that "different" way may be the one the person needed to hear to get the light bulb to go off!

Everybody understands things in their own way, so it's good to have things explained differently!
Click to expand...
Thanks Chris I appreciate it
 
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