? 4/26 Bijoux +10 253 - advice on PM dose

Brittanyb5353

Brittanyb5353

Member Since 2020
Hi! Bijoux and I had a long evening (but many thanks to Elise and Liz over on this thread for their help).

Long story short - yesterday was our first day of twice daily shots, 1 unit each. Her numbers were a bit lower than I'm used to going into the PM shot but were on the way up so I did 1 unit - she dropped a lot but we got her back on the rise.

This morning she's at 160 AMPS, I'm unsure if I should shoot and if so if I should give her full dose? I'm scared we'll end up in a similar situation to last night. Any advice is greatly appreciated - going to test her again in 20m.
 
Tested 20m later and she's around 188 now and eating breakfast. I'm hoping the best move is to give her the shot and recommended dose by the vet (1 unit).
 
Bron and Sheba (GA) said:
Are you following the Tight Regulation method or the Start Low Go Slow method ?
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Hi there! I appreciate at this point I should know more and do more research here but I’m trying to follow what my vet recommends and supplement that with everything I’m learning here (aka I’m overwhelmed and don’t know the best answer to your question I’m sorry!) I was giving bijoux 1 unit of lantus once a day for the last 9 days, took her to the vet yesterday and she recommended given bijouxs numbers that we go to 1 unit twice a day and yesterday was our first day on that.

thank you for the response!
 
Brittanyb5353 said:
Hi there! I appreciate at this point I should know more and do more research here but I’m trying to follow what my vet recommends and supplement that with everything I’m learning here (aka I’m overwhelmed and don’t know the best answer to your question I’m sorry!) I was giving bijoux 1 unit of lantus once a day for the last 9 days, took her to the vet yesterday and she recommended given bijouxs numbers that we go to 1 unit twice a day and yesterday was our first day on that.

thank you for the response!
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The reason I ask is because if you were following the SLGS method you would reduce the dose if the BG fell under 90 which it has done and your new dose moving forward would be 0.75 units both cycles.
If you were following the TR you would reduce under 50
 
Bron and Sheba (GA) said:
The reason I ask is because if you were following the SLGS method you would reduce the dose if the BG fell under 90 which it has done and your new dose moving forward would be 0.75 units both cycles.
If you were following the TR you would reduce under 50
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Thank you for this help! I’m going to do some reading this morning and figure out what the heck I’m doing/should be doing. I gave her the shot this morning (unclear if it was a fur shot or not) and monitoring every 20m for now to see how we go. Really really really appreciate you checking in and for the guidance :)
 
Brittanyb5353 said:
Thank you for this help! I’m going to do some reading this morning and figure out what the heck I’m doing/should be doing. I gave her the shot this morning (unclear if it was a fur shot or not) and monitoring every 20m for now to see how we go. Really really really appreciate you checking in and for the guidance :)
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Pleasure. Happy reading!
Ask lots of questions. You have a very knowledgeable group here that really cares.
 
tiffmaxee said:
Good morning. Since you can monitor I would suggest TR. I kind of assumed you were last night as you gave a shot. Did you shoot 1.0?
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Hi Elise! Good morning :) reading and researching now. I gave 1 unit but still not sure if it was a fur shot or not :-/ we were both a bit sleepy this morning. Last scan on the freestyle libre shows 170.
 
tiffmaxee said:
I hope you have a nice day. It will be interesting to see if a bounce occurs after all that time in green.
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Thank you - I hope you have a good day too! I'm curious and will ask later in the day after monitoring her numbers but since I was late with the shot this morning (gave between 8:20-8:40 instead of our normal 7:20-7:40 window), should I also do the evening shot later per normal protocol I guess?
 
Brittanyb5353 said:
Thank you - I hope you have a good day too! I'm curious and will ask later in the day after monitoring her numbers but since I was late with the shot this morning (gave between 8:20-8:40 instead of our normal 7:20-7:40 window), should I also do the evening shot later per normal protocol I guess?
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Yes. You need to shoot 12 hours after this morning’s shot. Shooting early can act like an increase which you don’t need. If this time long term won’t work for you, you can shoot 15 minutes early each cycle until you get to the time you want. How late were you?
 
tiffmaxee said:
Yes. You need to shoot 12 hours after this morning’s shot. Shooting early can act like an increase which you don’t need. If this time long term won’t work for you, you can shoot 15 minutes early each cycle until you get to the time you want. How late were you?
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About 45m to an hour late this morning by the time we got settled and were able to shoot.
 
The other option to getting back on time is to shoot 30 minutes early tonight and 15 minutes early in the morning but unless there’s a high bounce I wouldn’t shoot more than 30 minutes early tonight.
 
tiffmaxee said:
The other option to getting back on time is to shoot 30 minutes early tonight and 15 minutes early in the morning but unless there’s a high bounce I wouldn’t shoot more than 30 minutes early tonight.
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Ok thank you! I'll keep this in mind as the day goes on and see how we're doing :) really appreciate it!
 
I caught your post on Health and I'm going to repeat my suggestion here. It may be worth considering dropping Bijoux's dose to 0.5u twice a day. There are a couple of reasons.

First, if you opt to follow Tight Regulation, the initial dose is based on weight. Initial dose = 0.25 x ideal weight in kilograms. This usually ends up being around 1.0u or less. So, depending on how big of a kitty is, you can continue to shoot the 1.0u or drop it lower.

Looking at Bijoux's response last night to a twice a day shot, starting a bit lower will be easier on your nerves while you're still getting the hang of managing your kitty's numbers. You will likely need to systematically raise the dose back up but for now, this may give you more room to understand how Lantus is effecting Bijoux. (Also, 0.5u is the starting dose if you opt to follow the Start Low Go Slow method.)

Also, you will need to remember that having been dosing once a day means that Bijoux's depot is not fully formed. It takes roughly a week of twice a day shots for the depot to fully form.

Also, one housekeeping note. On this board, we recommend that you start a new thread (aka "condo") each day. This prevents a thread from becoming overly long. This is important if you are wanting quick advice. If I have to read through 75 posts in order to understand your question and the posts are from 5 days ago, I just can't read fast enough to be helpful in a timely way. (It also frustrates me to no end to have to weed through everything else that's there.) We have you cut and paste the link to the previous day's condo to your current thread so if we do need background, it's easy to backtrack. (The info is in the New to the Group sticky.)
 
Sienne and Gabby (GA) said:
I caught your post on Health and I'm going to repeat my suggestion here. It may be worth considering dropping Bijoux's dose to 0.5u twice a day. There are a couple of reasons.

First, if you opt to follow Tight Regulation, the initial dose is based on weight. Initial dose = 0.25 x ideal weight in kilograms. This usually ends up being around 1.0u or less. So, depending on how big of a kitty is, you can continue to shoot the 1.0u or drop it lower.

Looking at Bijoux's response last night to a twice a day shot, starting a bit lower will be easier on your nerves while you're still getting the hang of managing your kitty's numbers. You will likely need to systematically raise the dose back up but for now, this may give you more room to understand how Lantus is effecting Bijoux. (Also, 0.5u is the starting dose if you opt to follow the Start Low Go Slow method.)

Also, you will need to remember that having been dosing once a day means that Bijoux's depot is not fully formed. It takes roughly a week of twice a day shots for the depot to fully form.

Also, one housekeeping note. On this board, we recommend that you start a new thread (aka "condo") each day. This prevents a thread from becoming overly long. This is important if you are wanting quick advice. If I have to read through 75 posts in order to understand your question and the posts are from 5 days ago, I just can't read fast enough to be helpful in a timely way. (It also frustrates me to no end to have to weed through everything else that's there.) We have you cut and paste the link to the previous day's condo to your current thread so if we do need background, it's easy to backtrack. (The info is in the New to the Group sticky.)
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thank you very much for the response and advice I greatly appreciate it! And I definitely missed the condo bit in the newbie sticky so will make sure to follow this moving forwards. My only question would be do I need to get new syringes which show half unit measurements? The ones I have now show full units. Or do I eyeball it?

Again, thank you. Your message and everyone else’s have been so reassuring. I was just having a bit of a cry to myself but will gather my strength to keep improving on this for bijoux.
 
We do recommend syringes that are marked in half unit increments. There is information on syringes in this sticky.
Using syringes with a pen, cartridge, or vial:
  • U-100 3/10cc syringes with half unit markings are the best to use for drawing Lantus, Basaglar, or Levemir from vials, cartridges, and pens.
  • BD Ultra-Fine, CarePoint Vet, Monoject, GNP, UltiCare Vet Rx, Sure Comfort, and ReliOn are just some of the brands available with half unit markings.
  • Syringes come in ½ inch or 5/16 inch needle lengths. Needle gauges are 29, 30 or 31 (31 being the thinnest)
Relion is the Walmart brand syringe. ADW is a good supplier of syringes. To order online, you will need a prescription for syringes from your vet. If you go to the sticky, the syringes in the 2nd bullet point are linked to the ADW website.

It's also fine to eyeball the dose until you get syringes. What I'd suggest is to make a sample syringe and use a colored liquid (not insulin) to set your dose. That way, you can compare your dose to a fixed amount in the syringe. Another option is to use digital calipers to help measure the dose consistently. If you want to go that route, we have instructions.

Please keep in mind that the front end of this learning curve is overwhelming! There is so much to learn and I'm sure it seems like everyone here "gets it" and you're stumbling. I get it -- but I've been hanging around FDMB for 10+ years. If I wasn't conversant by now, I'd be a very slow learner. This will all become very routine.
 
Sienne and Gabby (GA) said:
We do recommend syringes that are marked in half unit increments. There is information on syringes in this sticky.
Using syringes with a pen, cartridge, or vial:
  • U-100 3/10cc syringes with half unit markings are the best to use for drawing Lantus, Basaglar, or Levemir from vials, cartridges, and pens.
  • BD Ultra-Fine, CarePoint Vet, Monoject, GNP, UltiCare Vet Rx, Sure Comfort, and ReliOn are just some of the brands available with half unit markings.
  • Syringes come in ½ inch or 5/16 inch needle lengths. Needle gauges are 29, 30 or 31 (31 being the thinnest)
Relion is the Walmart brand syringe. ADW is a good supplier of syringes. To order online, you will need a prescription for syringes from your vet. If you go to the sticky, the syringes in the 2nd bullet point are linked to the ADW website.

It's also fine to eyeball the dose until you get syringes. What I'd suggest is to make a sample syringe and use a colored liquid (not insulin) to set your dose. That way, you can compare your dose to a fixed amount in the syringe. Another option is to use digital calipers to help measure the dose consistently. If you want to go that route, we have instructions.

Please keep in mind that the front end of this learning curve is overwhelming! There is so much to learn and I'm sure it seems like everyone here "gets it" and you're stumbling. I get it -- but I've been hanging around FDMB for 10+ years. If I wasn't conversant by now, I'd be a very slow learner. This will all become very routine.
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Thank you so much for all this super helpful info!! Researching now! Bijoux has been hovering in the 170-180 range the last few hours so I'm thinking I either did a fur shot or only a bit got in but she seems okay so far otherwise.
 
She also could be bouncing from the lows. I hope you have a conversation with your vet tomorrow about dosing. By increasing to one unit unit twice a day you doubled the dose which is never recommended. Usually we increase by .25 increments. She’s also now on a low carb diet and we have seen many cats go into remission simply by diet changes.
 
tiffmaxee said:
She also could be bouncing from the lows. I hope you have a conversation with your vet tomorrow about dosing. By increasing to one unit unit twice a day you doubled the dose which is never recommended. Usually we increase by .25 increments. She’s also now on a low carb diet and we have seen many cats go into remission simply by diet changes.
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Yes absolutely - calling them first thing in the morning (going to try not to give her an earful) and going to play it safe per the recommendations here today. Also I sent her the spreadsheet here before her appt yesterday and she was thoroughly impressed by the thoroughness so I made sure she knew it came from here - kudos to whoever created such a useful tool!!
 
My vet loved the ss also and showed it to his students every time I was there when they rotated through. It got to the point that I managed the diabetes and he managed all the other issues as needed. I got pretty good with pancreatitis too unfortunately.
 
Just wanted to say hi! I think it's great that Bijoux was 160 this morning, you did a great job taking care of her.

I understand why you would cry, it's overwhelming. But you are really doing a good job.
 
Thank you all. I've just gotten no sleep and feeling overwhelmed but this is so helpful. I am getting more nervous leading up to the evening shot however. Am going to go on a run and try to clear my head and the nerves so I don't pass that on to poor Bijoux who's already been on such a ride these last 24 hours. Last scan of the Libre a few mins ago she was at a 225 and she's just tired today but eating well, urinating/pooping and grooming/purring some. I'm just scared to mess up again. This morning we were late with the shot about 45m to an hour, and based on the advice here I suppose I'll wait until 8-8:30pm instead of our normal 7-730pm to PMPS test, feed and give her shot. I'll likely post a new thread leading up to it in case my nerves haven't settled. Thank you all for the guidance, I don't know what I'd do right now if it weren't for you all. Hope you're having a lovely Sunday.
 
She’s doing fine and you are taking really good care of her.

Please don’t start a new thread. We ask that you gave one per day. Just change the subject and continue here.

When a cat has a BG lower Tasmania they are used to their body compensates by causing the BG to rise. The more time spent in normal numbers the less that happens. You have not seen very high numbers at all.

Take a break. Just enjoy her or take a walk. Or maybe take a nap.
 
Thanks for sticking with me everyone - went on a long walk in the drizzly weather and cleared my head a bit. Would love some advice as I near the PM portion of our proceedings today :) For the last 9 days I have been giving Bijoux her AM shot of 1 unit at approx 7:20-7:40 am. This morning we were late because I was nervous after last night and low numbers and wanted to be sure I was okay to shoot. Still unsure if I gave a fur shot or not but I gave 1 unit.

Going into tonight, as of 6:30pm here BG is reading 253. Because we gave the shot later this morning, and given the way she reacted last night I have a few questions/thoughts:
Option/Question 1: Since I gave 1 unit this morning (unless I fur shot it), should I hold off and skip the shot tonight and then switch to 0.50 units twice daily tomorrow (as well as speak to her vet in the am)?

Option/Question 2: OR should I attempt to give 0.50 tonight as her PM shot and then go .50/.50 tomorrow too? I'm just nervous after last night so want to be prepared just in case

Another question: since we were late this morning, ideally I'd love to get back on a 7:30am/7:30pm schedule - depending on the answer to the above, what are thoughts on if I am to test/fee/shoot a little earlier like 8:00-8:20pm instead of 8:20-8:40pm?

Apologies if this is a bit jumbled and/or really rookie questions - I know you all have given me brilliant advice above which I'll go back through now to see if I can answer my own doubts too.

Thanks again @tiffmaxee @Sienne and Gabby (GA) @Bron and Sheba (GA) @SingsToCats
 
Sienne and Gabby (GA) said:
I caught your post on Health and I'm going to repeat my suggestion here. It may be worth considering dropping Bijoux's dose to 0.5u twice a day. There are a couple of reasons.

First, if you opt to follow Tight Regulation, the initial dose is based on weight. Initial dose = 0.25 x ideal weight in kilograms. This usually ends up being around 1.0u or less. So, depending on how big of a kitty is, you can continue to shoot the 1.0u or drop it lower.

Looking at Bijoux's response last night to a twice a day shot, starting a bit lower will be easier on your nerves while you're still getting the hang of managing your kitty's numbers. You will likely need to systematically raise the dose back up but for now, this may give you more room to understand how Lantus is effecting Bijoux. (Also, 0.5u is the starting dose if you opt to follow the Start Low Go Slow method.)

Also, you will need to remember that having been dosing once a day means that Bijoux's depot is not fully formed. It takes roughly a week of twice a day shots for the depot to fully form.

Also, one housekeeping note. On this board, we recommend that you start a new thread (aka "condo") each day. This prevents a thread from becoming overly long. This is important if you are wanting quick advice. If I have to read through 75 posts in order to understand your question and the posts are from 5 days ago, I just can't read fast enough to be helpful in a timely way. (It also frustrates me to no end to have to weed through everything else that's there.) We have you cut and paste the link to the previous day's condo to your current thread so if we do need background, it's easy to backtrack. (The info is in the New to the Group sticky.)
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I'm leaning towards skipping a shot tonight - we haven't normally been doing them and I gave her 1 unit this morning. I'm thinking that tomorrow we SLGS with 0.5u in am and pm. Would love any input you have here :)
 
I think I'm going to skip her shot and start .5/.5 tomorrow and SLGS. Just did her +11 and it was 232. If I'm making a massive mistake please let me know EEK.
 
So you decided on SLGS? There’s nothing wrong skipping and thus draining the depot. That way you can get some sleep. She’s high enough to shoot but with the depot there’s a chance of another sleepless night.
 
tiffmaxee said:
So you decided on SLGS? There’s nothing wrong skipping and thus draining the depot. That way you can get some sleep. She’s high enough to shoot but with the depot there’s a chance of another sleepless night.
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Yeah - reading through, I think it makes most sense for us right now as the Freestyle Libre is coming off in 3 days and I will need to then get used to testing her more regularly and I think it just sounds like something we can ease into as I'm still feeling really overwhelmed. I wish I had read that when we first start this journey 9 days ago ufff. But yeah I think we both need some rest tonight and start fresh tomorrow.
 
Nothing is set in stone. Start with SLGS and see how it goes. You will adjust the dose weekly after doing a curve. You won’t need to test as much but will need am/pm tests and a few in between. Enjoy your evening. Last night was stressful and I’m sure a break will be nice.
 
tiffmaxee said:
Nothing is set in stone. Start with SLGS and see how it goes. You will adjust the dose weekly after doing a curve. You won’t need to test as much but will need am/pm tests and a few in between. Enjoy your evening. Last night was stressful and I’m sure a break will be nice.
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Thank you so much again, Elise! Hope you enjoy your evening too.
 
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