03-07 - Mumu - New member - AMPS 263

Sisu

Sisu

Member Since 2022
Hello,

I am wondering if anyone can chime in and try to explain whats going on.

Mumu has been receiving 1 unit of Lantus every AM shot where he is around 20 mmol/L and drops around +7 to +12 where he reaches around 4.5-13. I gave him 0.1 unit when he was 12 mmol/L in his pm shot where he dropped to 4.1 @ +2.5 so I am not giving his PM dose anymore.

Tonight his PMPS was 7.1 and I just checked him @ +2 and his BG is at 4.6 with no PM shot and he ate all his food of course.

Is the 1 unit carrying over from the AM? Should I reduce tomorrows dose? I dont understand whats going on.
 
Link to your previous post:
https://www.felinediabetes.com/FDMB/threads/1-10-new-member-mumu-amps-370.264369/

Lantus dosing is not based on preshots but on nadirs - how low a dose takes the cat. Lantus is also a depot insulin and likes consistency. You can get a true picture of what a dose is doing only by shooting the same amount across cycles. Frequent changes in the dose confuses the depot and you will not know which dose is actually working for him.

Also the normal range of blood sugar for a cat with a pet meter is 3.8-5.5 mmol. Rather than give only one shot, you want to try giving a lower dose AM and PM.

If you can update his spreadsheet and choose a dosing method, we will be better placed to help you. We are very data dependent here!
 
Bandit's Mom said:
Link to your previous post:
https://www.felinediabetes.com/FDMB/threads/1-10-new-member-mumu-amps-370.264369/

Lantus dosing is not based on preshots but on nadirs - how low a dose takes the cat. Lantus is also a depot insulin and likes consistency. You can get a true picture of what a dose is doing only by shooting the same amount across cycles. Frequent changes in the dose confuses the depot and you will not know which dose is actually working for him.

Also the normal range of blood sugar for a cat with a pet meter is 3.8-5.5 mmol. Rather than give only one shot, you want to try giving a lower dose AM and PM.

If you can update his spreadsheet and choose a dosing method, we will be better placed to help you. We are very data dependent here!
Click to expand...

Yeah it was just a pain to convert all the mmol/L numbers manually but i will do that again, will take awhile.

And to choose a dosing method i suppose slgs? I am just trying to give him the proper amount of insulin and properly increase/decrease it because what I described in the first post is in a nutshull whats been happening.

I cannot safely give him his second dose of 1 unit or he will drop too low and i dont understand why hes still dropping +14 his AM dose along with his PM supper and no PM shot.

And then in the AM cycle he doesnt respond well and is still high +6 but will begin to drop +7 onward till hes too low to shoot the PM dose base on giving him 0.1 unit @ 12.3 mmol/L and he fell to 4.1 @ +2.5.
 
You don't have to convert all the BG numbers. You are using the wrong SS. @Bandit's Mom can set you up with the right SS and it will convert into the US numbers on its own. Once we can see that, we can help you.
I don't quite understand what dose you are giving. Are you giving 1 unit or 0.1 unit? or both?
 
Bron and Sheba (GA) said:
You don't have to convert all the BG numbers. You are using the wrong SS. @Bandit's Mom can set you up with the right SS and it will convert into the US numbers on its own. Once we can see that, we can help you.
I don't quite understand what dose you are giving. Are you giving 1 unit or 0.1 unit? or both?
Click to expand...

Mumu has been receiving 1 unit of Lantus every AM shot where he is around 20 mmol/L and drops around +7 to +12 where he reaches around 4.5-13. I gave him 0.1 unit when he was 12 mmol/L in his pm shot where he dropped to 4.1 @ +2.5 so I am not giving his PM dose anymore.


One unit in the am I had explained in my first post, I am not giving his pm dose anymore because hes been going too low...
 
I was just wondering if i should lower his dose so i am able to give him 2 doses a day instead of one but i guess you guys need SS and a dosing method for that.
 
Even if you were to enter the data for last week or two, that would be a big help to us. We cannot advise on dosing without info on how he has been doing on each dose of insulin.

You have the right SS format if your meter reads in mmol/L and you are using a pet meter. You do not have to bother converting etc. Just enter the data in the World tab and it will automatically convert and populate the US tab.

I have sent you a request for edit access to your SS. Just need to tweak it a little for you to use.
 
Sisu said:
SS should be updated now.
Click to expand...
Yes it is. Thanks!

Looks like 1U maybe too high a dose for Mumu. You want a dose that you can safely shoot twice a day. Shooting a lower preshot is not an issue if (a) it's a good dose for the cat and (b) you can monitor after giving insulin. Lantus is very good at giving flat cycles when shooting lower preshots.

I think you want to try 0.5u from tomorrow and see if you can shoot it twice a day. With the TR dosing protocol, you can shoot any numbers over 68 and with SLGS any number over 90 (on a pet meter).

Tagging a couple of other members for their input on dosing:
@tiffmaxee
@Bron and Sheba (GA)
 
Bandit's Mom said:
Yes it is. Thanks!

Looks like 1U maybe too high a dose for Mumu. You want a dose that you can safely shoot twice a day. Shooting a lower preshot is not an issue if (a) it's a good dose for the cat and (b) you can monitor after giving insulin. Lantus is very good at giving flat cycles when shooting lower preshots.

I think you want to try 0.5u from tomorrow and see if you can shoot it twice a day. With the TR dosing protocol, you can shoot any numbers over 68 and with SLGS any number over 90 (on a pet meter).

Tagging a couple of other members for their input on dosing:
@tiffmaxee
@Bron and Sheba (GA)
Click to expand...

I don't think I have the nerves anymore to shoot on say 95-162 (I did on the 15th of June but he seems more sensitive to the insulin now) because I truly believe he might die if i give even 0.5u at that number mostly basing it off of the 0.1 I gave on the 24th of June and as well as that his BG is dropping in the pm after eating but that must be the 1 unit carrying over? I just don't want to have an emergency but most of all put my cat in danger.

By flat cycles what do you mean exactly?
 
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From what you are saying about your comfort level I think you should follow SLGS. That means reductions under 90. You would hold the dose for a week unless there’s a drop under 90. Whenever you see a bg under 90 you reduce and the count starts over. She has gone under 90 several times despite skips so I would also try shooting .50 and see how that goes. That will give you time to get used to lower numbers and gradually decide if you feel comfortable shooting lower numbers. What do you think?
 
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tiffmaxee said:
From what you are saying about your comfort level I think you should follow SLGS. That means reductions under 90. You would hold the dose for a week unless there’s a drop under 90. Whenever you see a bg under 90 you reduce and the count starts over. She has gone under 90 several times despite slips so I would also try shooting .50 and see how that goes. That will give you time to get used to lower numbers and gradually decide if you feel comfortable shooting lower numbers. What do you think?
Click to expand...

He* and OK that sounds like a plan, may I ask why we would skip 0.75 just curious is all .If he is at 100 and i shoot the full dose say 0.5U wouldn't it be assumed he would drop below 90 as there is very little room to fall to that BG?
 
Good questions. Slips was a typo I have corrected to say skips. I think both of suggest .50 because we want a dose you can shoot every cycle. Have you read the directions forSLGS?
https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/

That’s correct that you would not shoot a 100 bg. You would stall, NOT FEED and retest in 20-30 minutes to see if the bg is going up. If up slightly you could stall again depending upon how off schedule and depending on the bg and if you can monitor shoot a reduced dose or skip. I would suggest while stalling post for dosing advice by adding a question mark to your subject and writing AMBG OR PMBG dosing advice.
 
tiffmaxee said:
Good questions. Slips was a typo I have corrected to say skips. I think both of suggest .50 because we want a dose you can shoot every cycle. Have you read the directions forSLGS?
https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/

That’s correct that you would not shoot a 100 bg. You would stall, NOT FEED and retest in 20-30 minutes to see if the bg is going up. If up slightly you could stall again depending upon how off schedule and depending on the bg and if you can monitor shoot a reduced dose or skip. I would suggest while stalling post for dosing advice by adding a question mark to your subject and writing AMBG OR PMBG dosing advice.
Click to expand...

So i do have the option of stalling, token shot, or skipping.

If i do stall an hour or 2 and I give insulin wouldn't that mess up the next 12 hour cycle as the insulin would carry over? I have been religious about his feeding/injection times.
 
Sisu said:
So i do have the option of stalling, token shot, or skipping.

If i do stall an hour or 2 and I give insulin wouldn't that mess up the next 12 hour cycle as the insulin would carry over? I have been religious about his feeding/injection times.
Click to expand...

Yes. You can get back on schedule by shooting 30 minutes early every 24 hours. So it can be done 15 minutes early every cycle or 30 minutes every 24 hours all at once. Sometimes stalling can cause the BG to come down but often the BG rises making it safe to shoot a full dose or at least a token dose.
 
So say hes above 11.1 but below normal ps it says a reduced dose might be wise what would that be considered for a 0.5U regular dose?

tiffmaxee said:
Yes. You can get back on schedule by shooting 30 minutes early every 24 hours. So it can be done 15 minutes early every cycle or 30 minutes every 24 hours all at once. Sometimes stalling can cause the BG to come down but often the BG rises making it safe to shoot a full dose or at least a token dose.
Click to expand...
 
Sisu said:
So say hes above 11.1 but below normal ps it says a reduced dose might be wise what would that be considered for a 0.5U regular dose?
Click to expand...

I would stall and see if he comes up in 30 minutes. If over 150 shoot .25. If over 200 shoot full dose. If still under 150 skip for now. You can slowly lower the no shot number as you gain data and feel more comfortable.
 
If around 200 even if a little lower I would shoot the full dose and not stall provided you have supplies and can monitor.
 
tiffmaxee said:
If around 200 even if a little lower I would shoot the full dose and not stall provided you have supplies and can monitor.
Click to expand...
Thank you for the advice and everyone else as well.

Not sure why his BG rose from the AMPS though? Seems to me anyways like he is resistant to it during the day.
 
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