1/13 Moo; PMPS 220; Dosing questions

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Moosmommy

Moosmommy

Member Since 2012
Hi everyone,
I have been posting on the General Topic board but was suggested by some on there to come over here to get some fresh eyes and expert advice on my Moo and his numbers.

Just a little background. Moo started his treatment with 1.0 units of Lantus on 12/5/12
I dropped him to .50 and now he is at .25.
He is doing great and the last vet visit said he may be one of the lucky ones that is able to get OTJ sooner rather than later.
So we have been keeping him at .25 since then.
He has had some good nadirs but has been hitting some just over 200 numbers too.
Moo eats 1/2 can of friskies pate at 7am, 1130ish, 330ish, 7ish, then 1130ish pm as well.
I try to get some midday tests in on my lunch break but I am not always able to get home for lunch.
When Moo was diganosed he was at 10 lbs. Sept 2011 he was 20 lbs. Oct of this year he was 10 lbs.
He is now acting normal/peeing normal, etc and is up to a healthy 12.0 lbs.

SO Just wanted to get some expert feel on things here.
I of course am new to all of this and trying to feel my way around and learning from all of the great people on this website!
Thanks to anyone in advance for reading and for any advice or help you can suggest.
 
Re: New to posting on the Lantus board

Hi Annie & Moo and welcome to Lantus Land!

There is a ton of good information in the informational "stickies" at the top of the LL forum, so you have lots of reading to do. Start with the "New to the group" and "Tight Regulation Protocol". Whenever you have questions or need help with Moo, you can be sure that someone will be along.

In looking at your spreadsheet I think that you have room to go back up a notch in dose. I hope that one of the more knowledgeable people will take a look at your SS and advise you. It is good to get as many tests as your schedule permits. You don't have to cover all the time slots every day, but if you get tests when you can, patterns will gradually emerge. Be sure to get a bedtime test every day.

Lantus dosing is based on the nadir (the lowest number in the cycle; usually occurring somewhere around mid cycle), not on the preshots. Your SS shows very few tests in the evening cycle, so you don't really know what Moo does with his glucose at night. Those yellows that you see at AMPS may be a "bounce" from lower numbers at night.

Welcome again,

Ella & Rusty
 
Re: New to posting on the Lantus board

Hello and welcome to Lantus Land Annie and Moo. Great job getting your SS and profile set up. You'll find the people here are very helpful and there is someone on most hours of the day.

Speaking of which, since there are people from around the world, we tend to speak in terms of hours after the shot. Your 7AM is not be the same as mine. You'll notice that's how we have the SS set up. Can you speak to meals in the same terms? If 7 is your shot time, then meals would be at PS, +4.5 and +8.5 during the day and at PS and +4.5 at night. Some people put an * in their SS in the hours that they feed. Or you can record in the notes like you have, but it would be easier for others if you used the + notation. We tend not to feed much food after nadir, as the insulin is diminishing then and can less deal with the food.

And one last thing, if you have a question, it's best if you select the ? post icon above and put a summary of your question in the Subject line. For example, you might say 11/13 Moo - Dose Question? We have a convention of putting the date and cats name in the subject line too.
 
Re: New to posting on the Lantus board

Welcome to lantus land!

Fyi Every day you come on here and start a new thread/topic...which we call a "condo"

The subject should have the date, cats name and BG levels ie 1/13 Moo AMPS 343. And then if you take readings during the day you update the subject ie 1/13 Moo AMPS 343 +4 232. You can use the various emoticons to express things like ? Is a question, I is for information. Candle and rainbow are for cats that have passed so don't use those unless you want to scare us! 911 is for a serious emergency like a hypo.

In the body of the post you give a an update on how Moo is doing and a link to the prior days post. Take a look at some others here to get a feel of it.

People will visit your condo and comment and keep track of your kitty...

Also hoping an expert will pop in soon to answer your questions.
 
Re: New to posting on the Lantus board

We're sort of neighbors -- I'm in Chicago.

There's plenty of time to get acclimated to the conventions that we use here. One step at a time since it can be a bit overwhelming.

I agree with Ella. Moo's numbers are looking good. We tend to like green more than we like blue, though!

If your goal is to get Moo into remission, the more time he spends in normal BG numbers (50 - 120), the more opportunity his pancreas will have to heal. The Tight Regulation Protocol has an enviable record of getting newly diagnosed cats into remission. Based on that protocol, dose reductions aren't made unless numbers drop below 50. I would be thinking about increasing Moo's dose back to 0.5u.
 
So how do I know who the experts are on here?
If/when they comment do they identify themselves?

I didn't even think about the + numbers in my notes for the feeding schedule. I will see if I can get back in there and update that to keep in so everyone can understand it.

Thanks, and bare with me as I get the hang of all of this!
 
Hi Annie,

If you want to know the experts, they are generally the one giving dosing recommendations. Also look at their spreadsheets and how long they have been doing this dance. Oh, and Sienne is definitely one of those experts. :-D
 
For sure.... How many posts has sienne done...over 28k!! She is either very chatty or knows her stuff ;) and in her case it's definitely the latter.

If you aren't sure, then read some of their posts and see what they say and what others say to them.. See if it makes sense.. Or ask sienne ;)
 
So I just started a FAT .25 today... Do I give that a few days? Or do you think I should go back to .50 and see if we can get him into green?
And if so... What is my no shot # at that point?
Right now it is 160 with the .25 dosage.
 
Stick with the fattened dose for 6 cycles (3 days). Usually, you hold a dose for 6 cycles in order to both let the depot settle and to gauge the effectiveness of the dose. If numbers drop below 50 in a newly diagnosed cat like Moo before the 6 cycles, you decrease the dose.

On this board we use 150 as a "post and ask for help" number. You may want to take a look at this post on how to handle low pre-shot numbers. (It's also repeated in the sticky, Shooting & Handling Low Numbers.)
 
Yeah I read those stickies and handling low numbers things all the time just to refresh. I just get paranoid and I guess want a 'real time' answer? If that makes sense.
I was posting all ofmy questions on the main forum board. We had dropped him to .25 after he got REALLY low on christmas and raised his no shot number which we have been dropping the last few weeks and are now down to 160 with it.
It's so hard to do a .25 and a fat .25 with these syringes. They're kinda touchy. So I am trying (hoping) I am getting about the same dosage every time. I try to eyeball the same level but I feel like I never really know?
 
I'll ask Marje to stop by. She uses digital calipers to help with dosing consistency. I don't use them so I can't be of much help. I just use the lines and where the top of the syringe is as my guide.
 
Hi Annie

Welcome to you and Moo! Sienne asked me to give you some info about dosing with calipers.

I agree with her that Moo is looking pretty good and since you fattened the dose today, you should hold it for at least six cycles (unless he drops below 50) and reassess. I'd also suggest that with a newly dx kitty like Moo, I'd tend to increase and decrease by .25u instead of fattening or shaving doses. Most newly dx cats do better with .25u increases and, unless he fails reductions, it's better to do .25u decreases.

There is usually someone on to help you most hours of the day so we are pretty "real time" here. Just let us know when you have questions. We typically scroll up and down the condo list looking for questions and also looking for any new members whose kitty might have low (or really high) numbers.

I started using digital calipers when I realized how inaccurate the syringes are....it doesn't matter which ones you use...Relion, BD, Monoject, Terumos....they are all inaccurate and sometimes by alot. I'm not good at eyeballing doses.

I bought my digital calipers at Harbor Freight. Here is a post I wrote on Dosing with Calipers. You can di it no matter what syringe you use.

Pull in what you know is the consistent dose you've been giving and then measure it with the calipers. Measure in millimeters. Then each time you give the dose, you would measure that same dose with the calipers and not pay any attention to the actual dose lines on the syringe.

When you change the dose, remeasure with the calipers, and then you can dial the same dose in each time.

At the beginning, I measured how many mm were in 1u. Then I divided it by 14 as tht is how many drops I get to a unit. So each time I decrease a dose, I do it by the same number of millimeters.

Please let me know if you have questions. :-D
 
Thanks Marjie.

I think I should be ok when/if I take him back to .5
So today is day 2 of the fat dose.
After tomorrow (day 3) I should then go back to .50 on Wed and then see how his numbers lie?
If I go to the .50, do I keep my no shot level at 160? OR does it get raised since it is a higher dose?

I will check into the calipers too.
Thanks again,
 
I'm responding here because I don't see a condo for 1/14 yet.

Yes...hold the current dose for six cycles unless Moo earns a reduction. Then the next dose would be .5u. We ask that if you get a 150 or below, that you post and ask for assistance. It's possible we will have you shoot depending on the situation.
 
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