01/18 Edward AMPS 289

SnowKat

SnowKat

Member Since 2020
Yesterday’s thread #1 and thread #2.

I am due to shoot in about 30 minutes. I guess I’m going to stick with 1u?? I probably made a mistake last night, as I only gave him 1/4u, instead of the full 1u. I was just concerned that a full dose at PMPS of 144 would bring on the hypo monster overnight. I’d love some advice on dosing him today. TIA!

EDITED TO ADD: Let me try to better articulate my concern... 1u at AMPS brought him down from 282 to 108 - great! But what would 1u do to him at PMPS @ 144? I’m afraid he would drop another 100+ points into dangerous territory. Is this how it works, or am I thinking about this all wrong?
 
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I'm sorry you haven't received a reply yet. I'm sure someone will be around soon to give advice. The one thing I can suggest is to add a question mark to your condo. The question mark is in the drop down prefix menu, located in the condo. It may bring some more attention to your thread. I wish I could advise but, I'm not one of those experienced board members:)
 
Good morning!

Awesome job shooting that 1 unit this morning!
It would be nice if Edward's numbers today look like they did yesterday . . . down to a low blue at +7 with another opportunity to give more insulin tonight.

To answer your question about going down 138 points, and doing the same thing again from the 144; thankfully it doesn't work just like that, whew! He may have gone nicely low, even too low, but not down in equal measure. You'll almost have to witness to believe -- I know it's scary.
Part of the reason is that Lantus is made to be a background/ basal insulin, instead of a bolus that shoots numbers down fast. Lantus can keep people level for 24 hours, with small curves a couple times through the cycle. It is intended to do the same for a cat in 12 hour cycles. However, with our felines, we want the Lantus to also bring down those high numbers, which it can:)
You will learn a lot - I absolutely love the spreadsheets for trying to predict what our cat is going to do! If you have time, it helps a lot to look at other's spreadsheets.

I hope you have a great day, and we will be watching the beautiful Edward! Oh - make sure to draw attention to yourself if you need help (or bump your thread) - go ahead and use that pull down question mark to the left of your title. When the moderators and others see it, they will get to the question marks first. I know you put one at the end . . . I'm just telling you that because I was here for weeks before I finally saw the pull down thing:woot:
 
@Tina Marie and Jan thank you for that reassuring response! This is such a steep learning curve, sigh.

OK, so we are back on track with 1u today. His BG doesn’t seem to be responding as quickly as it did yesterday... we will continue to monitor. I guess my big question is, assuming his BG is in the mid-100 or higher, should I go ahead and shoot 1u tonight, and just set alarms to wake up and monitor throughout the night? What do you think?

More questions... Is there some sort of “cut off” or “cut dose” level that I should keep in mind? Do I want to aim for 2 equal doses per day, or do I want to adjust based on pre-shot BG, assuming I am home-monitoring?

Also... I can’t find how to add a “?” to the left of my title... I am on my phone - maybe I need to access via computer??
 
Read This! (sticky at top of Lantus Forum)
I know it's so much to read, but you want to decide whether you want to choose Start Low, Go Slow, or Tight Regulation.
Then you will know at what numbers to reduce (under 50 or under 90), and how long to hold doses (one week or 3 days (6 cycles)).

Lantus dosing is based on how low the insulin dose takes your kitty, NOT on the pre-shot numbers. When more experienced, you will be excited to shoot green (under 100) pre-shot numbers. At first it is very un-nerving after watching the insulin take the numbers down so far.

If the numbers start going too low, regular, low carb food will help the numbers stay steady or go up a little (still watch/check BG to make sure). But if it is early in the cycle, a medium carb food could be fed to prevent going too low. The timing of food can be very helpful. Many people feed their cats during the first part of the cycle - say before +6, and not much, if any until PMPS. That's because the insulin may be waning after the nadir/peak (lowest BG of the cycle, commonly from +4 to +6).
You do not want to feed 2 hours before a pre-shot test, to keep the reading from being food influenced.

OK! Yes, we want to have equal doses, day and night as often as possible. Keeping the same dose helps everything balance out, including the depot (so much to learn, don't let me stress you). We can't find or be sure of the correct dose if the doses aren't consistent. If you choose SLGS (start low go slow), you reduce by .25U if Edward goes under 90. If TR, you don't reduce until he goes under 50. Side note - my Tina went off insulin Dec. 6. Completely normal numbers for her are in the 50s.

If Edward is over 150 (maybe even 100) before tonight's dose, I think you'd be advised to shoot the 1 unit - provided you will be able to set alarms if necessary!! But we still want to know the pre-shot number anyway! (Even though I said Lantus dosing is based on nadir, not pre-shot.) A general rule is NEVER shoot if the pre-shot is under 50. That would only be for very experienced people who knew their cat well!

I never post from my phone (just read on it) - so I don't know! It's a little box to the left of 01/18 Edward . . . if you can edit your title, the drop down box is at far left!
 
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@Tina Marie and Jan thank you for such an informative response! That is super helpful and reassuring. I will scour the link you provided. I read it a few days ago... but everything has changed once I actually started dosing and watching the BG fluctuate (it’s amazing and frightening at the same time, LOL). And of course I’m terrified of doing anything that could make the situation worse. But I’m gonna be brave tonight, and assuming everything looks good, I’ll shoot the 1u and monitor.

And CONGRATS on your fur baby’s remission!!! That is phenomenal
 
 
@Tina Marie and Jan I appreciate the encouragement, and I totally understand that the kind and knowledgeable folks here have their own lives - I definitely don’t expect instant responses. I have been more than amazed at how responsive everyone has been. This is a fantastic group of people and I am SO fortunate to have found it.

Question... can you see Edward’s spreadsheet? I think I may have had it set to private until this morning. I think I fixed it, but I’m not exactly sure...
 
Only 2nd day on Insulin for Edward. Depot hasn't even filled yet.

Do you have your hypo toolkit ready to go in case it's needed?
 
SnowKat said:
EDITED TO ADD: Let me try to better articulate my concern... 1u at AMPS brought him down from 282 to 108 - great! But what would 1u do to him at PMPS @ 144? I’m afraid he would drop another 100+ points into dangerous territory. Is this how it works, or am I thinking about this all wrong?
Click to expand...

That's not really how it works with Lantus, we often find that at lower numbers the cycles actually flatten out. Lantus isn't an in and out insulin. That said, you are very new, and it is important to get a better picture of how your cat responds to insulin and carbs. With not much data, and since you are following SLGS, we often suggest to people just starting out that you don't shoot numbers under 150 until you gather more data. What you want to be able to get a feel for is onset (when insulin reaches bloodstream and starts to lower blood glucose), nadir (lowest point in the cycle) and duration (how long insulin continues to lower blood glucose) for your own cat, since every cat responds differently.

I know this is a steep learning curve, with a lot of info, but keep asking questions as you read through those stickies, there are a lot of folks here who are happy to help :)
 
You all are AMAZING! So, in light of all the excellent advice you’ve given, and re-reading the Lantus protocols for both approaches (still not sure which one I am following...), and Edward’s numbers today, I am confident that an evening dose of 1u is appropriate.

How does one determine which approach to follow? Thankfully we have no problem with home-testing. We are testing every 3 hrs during the day currently, over the weekend for his first 3 days on insulin. I can test M-Th at AMPS, +6.5, and then regularly.

Should we aim for TR??
 
SnowKat said:
How does one determine which approach to follow?
Click to expand...
Whatever suits your life style and comfort level/goals. If remission is a goal, TR is more likely to get you there, though we do have cats on SLGS do it too. Some people just can't test much due to work/life, etc. or cannot get their kitty onto an all low carb wet or raw food diet.

As for testing schedule, once you've figured out Edward's onset, nadir and duration, you'll be able to test more strategically.
  • Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
  • Peak/Nadir - the lowest point in the cycle
  • Duration - the length of time insulin continues to lower blood glucose
 
Thank you @Wendy&Neko - we are defiantly working toward full understanding of how Lantus effects Ed’s BG. My approach and education are evolving hour to hour at this point ‍♀️
 
Welcome to the LB&L Forum SnowKat! I'm sorry I wasn't around much in the last day or two to see your first post here - but it looks like you've gotten some wonderful advice above and are well on your way.

Wonderful to see you learning by the minute. It's quite a journey, this one. Take your time and be patient...a new factoid will stick in your memory every day...:D:D
 
I just shot 1u and Ed didn’t even flinch.

I cannot thank you all enough for the advice and warmth you’ve shown me.

Another question... am I crazy or does insulin smell weird? Like bandages and hospitals...? I am very sensitive to smells.
 
Yes, Lantus smells like bandages. If after you shoot the fur is wet, that is called a fur shot (FS) and it means not all of the insulin got injected into your kitty. Never, ever give a second shot of insulin because you have no idea how much insulin went into your cat on the first shot. If you give a FS, document that so if you get wonky high numbers you have some idea why.

Could you smell the insulin because of a fur shot?
 
SnowKat said:
Also... I can’t find how to add a “?” to the left of my title... I am on my phone - maybe I need to access via computer??
Click to expand...
This is where you find it on a computer, it should be similar on your phone. On the right hand side of the screen there is a tab to edit your title. When you click that you see something like the picture below. In the title textbox it says (no prefix) and a down arrow is right beside it. Click the arrow and you have choices like: 911 (used in emergency situations), GA (Gone ahead, the kitty has passed on), ? (when you have a question). After your question is answered, remove the question mark in your title.

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SnowKat said:
I’ve been pressing out a tiny amount of Lantus along with any bubbles before injecting.
Click to expand...
Give the syringe a couple of sharp flicks /taps, with a couple of fingers, needle pointed up to get any air bubbles to the top of the syringe. You can also give the plunger a bit of a slow twist to twist out the last bubble. Before using the syringe, slide the plunger up and down a couple of times, to spread the lubricant in the syringe and make it easier to draw the dose.
 
Welcome Snowcat ! It’s overwhelming at first but you will understand a lot soon . These folks are so helpful here . I was learning in no time . I’m still learning though . My salem was diagnosed this August . We started insulin on the end of October after he almost died . We started on a food diet first to control his sugar because of money . We got a slow start on the insulin . Be sure to watch for ketones too . It’s two ways you can check for ketones with urine strips or a meter . I prefer a meter . It’s easier and you catch it sooner in the blood . It’s expensive but well worth your kitties life ! I was fortunate to have @Sandi & Whisper come to my home to teach me . She lives near me and she got me started quickly . she was so wonderful she even came to the house he’s first hypo to teach me at 11 pm at night ! She also visited salem at the er hospital and brought me supplies and she helped me give salem fluids when he wasnt drinking enough water . I have learned a lot from this board. these people are wonderful ! Welcome !!!
 
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I would definitely print the stickys I made a notebook with them all in it so I could go back to refer to it all . You will make some bad decisions but rest assure these people will help you get back on track ! Just think it all out if your scared dnt feel its a right decision wait get help but you will have to sometimes think it out yourself if everyone’s busy but that hardly ever happens here just holidays . These people respond pretty quickly !
 
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