06/10 Boomer +16 65

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Judy and Boomer

Judy and Boomer

Member Since 2014
UGH well this was the situation, again, which I was hoping to avoid by decreasing his 3rd dose. But he never did come into the green yesterday so I was thinking that his 3 shot cycle might be extended to 4 because of the reduction of .5 instead of .25. But noooo.....holding true to form at the time of his fourth shot he's low . And I'm going to work and my husband will be away from home for a while today so, once again, no shot for Boomer.

So....I'm planning ahead and I know this goes against the protocol but Boomer doesn't seem to be following it anyways! Here is my thought.....Boomer will get .75 tonight and .75 tomorrow morning. Tomorrow night (his 3rd shot) I would like to reduce it to .5 to try to head off that low level that will happen thursday morning that I don't like to shoot at (especially when I'm not here to monitor) and which caused problems Saturday evening.

Your thoughts???
 
Re: 06/10 Boomer AMBG 81

You will drain the depot a little this morning. You will begin filling the depot with the 0.75, and then reduce to 0.50, but the depot will still be partially filling up with the 0.75 dose. Lantus dosing doesn't take effect immediately. It's a depot insulin, so it often takes 3 days for the depot to match the dose. Of course, Boomer's depot is so often never quite matching the dose because it seems to be constantly filling and draining. Just my thoughts.
 
Re: 06/10 Boomer AMBG 81

This could be just my not understanding lantus totally.....but my thought is that when he spends two cycles in the blue the depot is filling and then when he comes down into green the depot is filled?
A full dose when he is green just seems to be too much for him.
 
Re: 06/10 Boomer AMBG 81 +4 65, +5 79 question about depo

Boomer surfing the greens today.

I'm trying to understand the lantus depot a bit better. Does the insulin go entirely into the depot and then gets released into the bloodstream once the depot is filled?
 
Re: 06/10 Boomer AMBG 81 +4 65, +5 79 question about depo

Have you had a chance to read this sticky about the Insulin Depot? Lots of good info.

When you are filling the depot, "some" (likely a little) will go into the bloodstream and some goes into the depot. As the sticky notes, there are a lot of variables and then throw in the old ECID. So it's good that you noticed this pattern with him because that's how you should be looking at it....the waves and not one isolated cycle.
 
Re: 06/10 Boomer AMBG 81 +4 65, +5 79 question about depo

Yes I've read the sticky but just re-read it!
So with Boomer.....he is in the blues when the depot is filling up. Then goes into the greens once the depot is filled and therefore more insulin goes into the bloodstream. So I guess the trick is to be injecting just enough that whatever is being released into the bloodstream is being replenished from the shot??

Specific to Boomer.....his levels were high for the last couple of days (depot was filling up) then during the night they came down (last night's shot filled the depot). Today he has "extra" insulin in his bloodstream so his levels are low (but not too low). He'll go back into the blue later today. .75 at 6:00 pm. Another .75 at 6:00 am tomorrow. Historically the third shot which would be Wednesday at 6:00 pm moves him into the green and the fourth shot doesn't exist. So if I reduced the third shot to .5 would that not allow the depot to fill up and release a bit less to his bloodstream so that hopefully his BG will not be so low thursday morning that I don't want to shoot?
 
Re: 06/10 Boomer AMBG 81 +4 65, +5 79 question about depo

this is not what we would normally suggest, but i'm going to throw it out there as a choice for you to consider.

shoot low to stay low works very well when the dose is at the right amount. i think the problem we've got going with boomer is that the dose is too much. The dose is too much because his pancreas is healing, so we've got a constantly changing situation with him and you aren't being able to consistently stay with one dose for even 4 shots. we "think" we've got the right dose, then you shoot low, and Boomer goes in the basement and wants to stay there for the rest of the cycle. That's not a good situation, and certainly different from the typical response to shooting low.

so . . . i think what i would do is reduce in advance. you skipped this morning, but instead of going back to 0.75u tonight, i'd go to 0.5u and use that as his new dose.

it's not by the protocol. but he's not letting us follow the protocol! so i think a creative non-protocol solution might be worth trying.

if he doesn't hold the reduction and his BGs trend up, then we can go back up in dose. i'd say watch carefully and if you see the numbers going up, don't wait, go right back to 0.75u. This might not work, but if it does, it will keep you from staying up all night. I'd also be ready tonight to check +1 and carb him in advance if you see him headed down the basement stairs. if ya know what i mean!

it's up to you, of course - but based on his recent history, i wouldn't go back to 0.75u tonight because i think you'll for sure be in low numbers tonight if you do.
 
Re: 06/10 Boomer AMBG 81 +4 65, +5 79 question about depo

Hi Julie....
I believe I read that the depot will adjust itself quite quickly to the dose. Your message made me wonder....if I shoot .5 tonight will the depot suddenly feel overfull and release even more into his bloodstream and then he...to use your term....goes to the basement?

I absolutely know that this is not the ideal solution! What if I don't shoot again tonight to let the depot drain then start with .5 tomorrow morning?
 
Re: 06/10 Boomer quest. about tonight's dose in +3

As much as we would all love to know our crystal balls are working all the time, unfortunately they don't. And, obviously, especially with regard to Boomer.

The depot does not always quickly adapt to the dose; that's why we make dose increases slowly.

I think Julie is right that we need to come up with some other solution here. I do think Boomer's pancreas is helping out quite a bit which, IMHO, might be the reason why we are seeing his cycles look like they do. I, personally, don't want to guess what will happen if you shoot 0.5u tonight because I do agree it's not the ideal solution. Every time you skip a shot, shoot a reduced dose, etc, you mess with the depot. I think Julie's point is just trying to get him to a dose that you can consistently shoot.

I know you don't need a recurrence of what happened Saturday night. I think it has to be your decision whether you shoot tonight or skip and whether you start again tomorrow. You might want to let today's numbers decide. If he trends up, I'd strongly consider shooting tonight. But it's up to you.
 
Re: 06/10 Boomer +10 66 PMBG 86

Well I didn't shoot PM. Mainly because he's only 86. And partially because just as Boomer started to eat someone rang our doorbell...and off goes Boomer into hiding. Got him to eat a wee bit after that but he was skittish and really not interested. He'll be really hungry by pre-bedtime snack.

So I'll see where his levels go from here but I'm planning on shooting tomorrow AM .5u.
He has followed his own little protocol of 3 shots then a break even through previous reductions so I wouldn't be a bit surprised if I'm still faced with a low pre shot level on Thursday PM. But we'll see what tomorrow brings.
 
I believe I read that the depot will adjust itself quite quickly to the dose.
Click to expand...

cats respond differently to insulin - it's a hormone. the action of a hormone is variable - we have a saying "ECID" meaning "every cat is different." There are general statements we can make about most cats, but we often find that cats don't read the manual.

Regarding your comment above, sometimes when a dose is reduced we can see that the depot might be influencing as many as the next 6 cycles. Just depends on the cat. I wouldn't assume that the depot will adjust quickly, but when you skip a shot you're making a greater impact on the depot than just reducing the dose a small amount.

As you do different things with Boomer, you're gathering data that helps us see how he responds and perhaps helps us figure out what to do next. Boomer's definitely keeping us on our toes!!! :-D
 
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