10/11/14 Oz AMPS 182 - Do I lower the dose?

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Ian & Oz

Ian & Oz

Member Since 2014
Hi All,
I just checked Oz before his shot & he's at 182.
He had a 95 at +4 yesterday but then a 354 at pre shot last night.
He's currently on a dose of 1.75u, don't know whether to give same dose, or lower it & by how much.
According to the sticky I either lower the dose or feed as usual then test again, not sure what to do & it's shot time.

Ian
 
Re: 182 at pre shot - Do I lower the dose?

Ian,

Are you home today to test? Do you have enough test strips and some high-carb food on hand just in case?

You can always stall and re-test in 20 to 30 minutes to see if the number is rising. If you do stall, don't feed yet. You don't want the food to influence the number when you're stalling.
 
Re: 182 at pre shot - Do I lower the dose?

Either Erin or I will be here & we do have enough strips & for carb food we have some Fancy Feast Gravy lovers, it'sTurkey I think.
Worried about how low he could go.

Ian
 
Re: 182 at pre shot - Do I lower the dose?

Shelly,
If it hasn't risen then do i lower the dose if so where would I go to from 1.75u?

Ian
 
Re: 182 at pre shot - Do I lower the dose?

I'm assuming you're stalling without food and will re-test in a few minutes. If so, let's see what the next test shows. If he's still dropping, you can always do a one-time reduced dose if it makes you more comfortable.

Most people on TR will shoot the full dose, but I know that's really scary for you right now. As long as you are testing and have high-carb food, you can steer the numbers if they go too low.
 
Re: 182 at pre shot - Do I lower the dose?

How did the re-test go? If I'm right, you're about 45 minutes past the normal shot time now. You don't want to stall much longer or it's going to throw your shooting schedule off quite a bit. (I don't know how much flexibility you have with moving your shot times.)
 
Re: 182 at pre shot - Do I lower the dose?

Hi Shelly,
I re tested at 9:35 & he was at 207, so I gave him the regular 1.75u dose.
I know that he's still starting lower than normal so his numbers will probably be lower, just hoping to catch that
& feed him & steer it as you said. We will probably/possibly have a lower pr shot tonight, what do we do if it is below 200?

Thank You
Ian
 
Re: 182 at pre shot - Do I lower the dose?

As long as he's above 50 then we don't have to give any honey (what we have ) or high carb food, is that right?

Ian
 
Re: 182 at pre shot - Do I lower the dose?

Since he got his shot at 9:35, do we have to give tonight's shot at the same time or can it be at 9:00 like usual?

Ian
 
Re: 182 at pre shot - Do I lower the dose?

Nice shooting Ian :thumbup

If he is at a number that you are uncomfortable shooting tonight, do just as you did this morning, and post for help.
Always try to keep a stock of extra test strips and some high carb food and/or karo or syrup.

Whenever shooting a lower than normal pre shot test, I would start the cycle with a +1 and +2 test, and probably a +3 and then go from there.

Normally if you want to move your shot schedule (if you want it back to what it was before the stall today) then we advise doing it by either 15 minutes each cycle or 30 minutes once per day.
 
Re: 182 at pre shot - Do I lower the dose?

Glad to hear you shot the full dose!

Oz is responding really well to the insulin, and, although he is bouncing a bit, he's clearing the bounces really fast. Last night for instance - he bounced at PMPS but then immediately started back down. That's fantastic. (Some cats bounce for the full 3 days before they start coming back down.)

On Health, the recommendation is to not shoot anything under 200 without posting first. Here, that "limit" is 150. However, any time you get a number that you aren't comfortable with, you can always post and ask for help - just like you did this morning. Since you stalled this morning, you'll need to shoot 12 hours from the time you shot this morning. You can move back to your normal test time by shooting 15 minutes early per shot. Does that makes sense?

You might try grabbing a +2 test today. That's often a very good indicator of what will happen during the rest of the cycle.

Now that you've shot, you might change your subject line to the "standard" format - 10/11 Oz AMPS - 207. And here's the link to your post from yesterday: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=126755. We try to link back to the previous day's thread so that people have any easy way to click back and see what's been happening.

I have to run out for about an hour, but I'll be back soon to check and see how you and Oz are doing. Great job this morning! :-D

Edit: Sorry to repeat the info Dyana gave you. I didn't see her post before I submitted mine. ohmygod_smile
 
Re: 182 at pre shot - Do I lower the dose?

ian said:
As long as he's above 50 then we don't have to give any honey (what we have ) or high carb food, is that right?

Ian
Click to expand...



If he goes below 50, then yes you want to give a little HC, or maybe start with MC and see if that will raise his numbers. It depends upon how fast he is dropping. Hopefully, he will just surf along really nice, today.
 
Re: 182 at pre shot - Do I lower the dose?

Great job this morning!

If you recall what I said last night, there's no way to predict how long it will take for a bounce to clear. Oz is doing a great job of bring his numbers back down.

If a may, there are a few housekeeping items that will help. Remember to put the date and Oz's name in your subject line. That will help you to find Oz's thread (we call a thread a "condo") and likewise, helps us to know it's your kitty what which condo is current.

It's also helpful when you're juggling low numbers to make sure your spreadsheet (SS) is up to date. The first thing many of us look at when someone is needing help is your SS. Today, the 207 was the number you shot, that's your AMPS. The 182 would be your +12. You can put that information in the comments, or stack the numbers in the AMPS cell. (Look at Gabby's SS to see what I do.) When you stack numbers in the cell, you have to manually change the color.

As for shooting tonight, let's see how the cycle goes. You can definitely shoot 15 min. early. If Oz isn't sitting in lower numbers, you can probably shoot on time. In general, you can shoot 15 min early at every shot time or 30 min early once a day without there being much of an effect on the numbers. With Lantus, an early shot acts like a dose increase whereas a late shot acts like a dose reduction.

You may also want to take a look at the sticky, Handling & Shooting Low Numbers. It's looking like Oz may want you to be prepared!
 
Re: 182 at pre shot - Do I lower the dose?

Hi Ian...you are already getting advise from the experts...I just wanted to say "hi" and tell you are doing a great job monitoring Oz!
 
Re: 182 at pre shot - Do I lower the dose?

Thank You Shelly, Dyana, Sienne & Monets Mom,
I really appreciate your replys.
I tested again at +1 7 he's at 194, I'll test again at +2 & +3 & more I'm sure.
Dyana, is HC & MC high carb & medium carb food, & if so what are some examples.
I see everyone mention Karo syrup, my vet told me several things & one was honey so that's what we have, is honey ok
or is Karo better?
I'll have to get used to what to put in the header here in this forum, this morning the only thing I could think about was, what do I do now.

Thank You
Ian
 
Re: 182 at pre shot - Do I lower the dose?

Hi Ian,

Yep - "MC" is medium carb and "HC" is high carb. Hopefully someone will correct me if I'm wrong on this - I believe MC is 10% to 14% carbs; HC would be 15%+. You can take a look at Dr. Pierson's food chart for some examples: http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf. Fancy Feast Gravy Lover's would be considered a HC food according to that list.

Honey is perfectly okay to use if you need it. Karo, honey, maple syrup....they'll all work if numbers are below 50.

Hey - when you're dealing with lower numbers than you're used to, you don't always have time to stop and think, "How do I format this?" You'll pick it up as you go, so don't stress about it. The important thing is that you did a great job this morning, and you're doing a great job testing.
 
Re: 182 at pre shot - Do I lower the dose?

I'm reading the Shooting & handling low numbers info, I see where it's talking about giving a shot when the preshot level is 50.
If the pre shot level is 50 you would be at a reduced dose, is that correct?
I can't imagine giving the same 1.75u dose if Oz was at 50, but maybe I don't understand.

Ian
 
Re: 182 at pre shot - Do I lower the dose?

ian said:
I'm reading the Shooting & handling low numbers info, I see where it's talking about giving a shot when the preshot level is 50.
If the pre shot level is 50 you would be at a reduced dose, is that correct?
I can't imagine giving the same 1.75u dose if Oz was at 50, but maybe I don't understand.

Ian
Click to expand...
Eventually, you'll get used to lower numbers and crave them ;)

A number below 50 would earn Ian a dose reduction, if he has been diagnosed for less than a year.
People with lots of experience and have been testing a lot and have lots of data, can shoot a 50 or above. You don't have to think about that right now.

I use Fancy Feast Medleys as a medium carb food as I think they are about 12% to 14% carbs.
 
10/11 Ian AMPS 207, +1 194, +2 136

Is this Subject Line correct /\ ?

I would give him some low carb food, not a ton, just some, to try to get him to slow down a bit.
 
Re: 182 at pre shot - Do I lower the dose?

Dyana,
Yeah, I just did another test & he was at 136, you say I should feed him a little?

Ian
 
Re: 182 at pre shot - Do I lower the dose?

Just to add to what Dyana said - yes, most experienced members who are testing a lot will give a full dose at 50 or above. The motto is "shoot low to stay low."

Take a look, for example, at (Marje &) Gracie's spreadsheet: https://docs.google.com/spreadsheet...sfdGs1aXhwSVZCLWRTR0NWUGxTR2xfbnc&output=html. Specifically look at last night's PM cycle. Marje shot the regular dose with a PMPS of 61.

Here's another example from (Shawna &) Davidson's spreadsheet: https://docs.google.com/spreadsheet/pub?key=0Aj3uT59Jr1qSdHAzZGdodHR1NVFwb1FHR0hOOTRwQ3c&outpu Look, for example, at the AM cycle on 2/26. Shawna gave 2 units with a pre-shot of 59. Do you see how the numbers stayed relatively flat throughout the cycle? I know it's strange to wrap your head around how the numbers can stay flat like that.

Quite frankly, I thought the TR people were "crazy" when I first joined and saw people giving insulin when their cats were in the 50s and 60s. Eventually, I became "crazy," too, and started gradually shooting lower numbers. :lol: It's amazing how it works.

As Dyana said, don't worry too much about it right now. You'll gradually ease into shooting lower numbers.

Yep - perfect subject line! And you can absolutely give him food.
 
Re: 182 at pre shot - Do I lower the dose?

Yes. You don't want him full, because you may need him hungry and willing to eat later, so just give him like an extra large eating teaspoonful (as opposed to a measuring teaspoonful).
Test again at +3.
 
Re: 182 at pre shot - Do I lower the dose?

Dyana,
Well I fed him, but it was 2 or 3 good sized spoonfuls.
Hopefully he'll still be hungry if need be, so far he's been hungry all of the time.

Ian
 
Re: 182 at pre shot - Do I lower the dose?

That's fine. You can always use honey, if you have to, but I would take up any left over food for now.

Do you see how the 207 and the 194 are pretty close to the same number?, and how at +2 he came down? That's why the +2 tests with Lantus are important. Lantus will often have it's onset (when the insulin starts to take effect for the cycle) at +2.
 
Re: 182 at pre shot - Do I lower the dose?

When do you know that you should reduce the dose, meaning if 1.75u is starting to work for him now, I've seen others charts where they began reducing the dose & the numbers stayed in the same range.

Ian
 
Re: 182 at pre shot - Do I lower the dose?

You reduce any time the cat falls below 50 on a given dose (assuming he is newly diagnosed) or if he stays in normal numbers (e.g., 50 to 120) for a week.

By the way - you did a perfect job updating your subject line, but you need to do it on the very first post you made in this thread. Otherwise, it doesn't show up on the main page. Ya gotta love technology, right? ;-) Sorry I didn't catch that earlier. I've been cross-posting with you and Dyana all morning, it seems. ohmygod_smile
 
Re: 182 at pre shot - Do I lower the dose?

Hi Shelly,
Not sure which part to update.
Also, wondering about his food, I've been leaving it out as usual, like you did, so it's pretty much always there
that way when he's tested it's showing numbers with his normal routine.

Ian
 
Re: 10/11/14 182 at pre shot - Do I lower the dose?

We usually start with the date, then the cat's name, and then the numbers for the day. As you get additional numbers in, you can go back and edit the subject line (again, of the very first post in the thread) and add in the new numbers. So, you can put something like this: 10/11 Oz AMPS - 207, +1-194, +2-136, +3-130.

If you have a question, you can always put it in the subject line, too. For example, I might have put something like this when I had a question: 3/10 Jersey AMPS-76, Dose increase?

By putting the day's numbers in the subject line (of the very first post), it lets people see at a glance from the main page what's going on with our kitties. It's just an easier way to keep an eye on everyone if we can see from the main page what's going on.

Yep - I fed Jersey pretty much whenever she asked for food (except for the two hours before each shot time). She always ate after her AMPS and PMPS. Then, she would generally "ask" for food again around +1 to +2. She might not ask for food again until +3 or +4. I just kind of left it up to her when she wanted to eat. With three indoor cats, whatever I put down usually didn't last long.

We steer numbers with food. As you start dealing with lower and lower numbers, you're going to use food to "steer the curve." If you notice Oz headed lower, you can give food to slow down the drop - just like Dyana mentioned. If the numbers are too low, you're going to use food to raise the numbers. Jersey was an easy cat to deal with. She seemed to have an insatiable appetite, and, with the exception of one night right before she went into remission, I was always able to get her to eat when she went low - even if she had already eaten three times in the past two hours. Every cat is different, though, and you'll have to find out what works best for Oz. Food experimentation is something that's really common, and I think you'll soon find out what feeding schedule and what feeding "habits" Oz has. I'm also sure others will be able to give you great tips about what worked/works best for them.
 
Shelly,
With all of the testing & monitoring that has to be done, I'm wondering how to do other things that need to be done & involve leaving home for awhile. Is there a point where he starts to level out & you can trust the numbers enough to go somewhere?
At the moment I'm doing some extra work for somone but working from home, I do need to randomly be gone for a bit, how do you handle that?

Ian
 
A lot of people here use timed feeders at night or when they have to go to work. The PetSafe 5 feeder is the one I bought based on recommendations I received. I set it to open during the night, and then left the last compartment empty and set it to open 2 hours before the morning shot. That way, I didn't have to get up in the middle of the night and pull the food. I could also set it to open several times while I was at work. That way, Jersey would be able to eat if she started going low while I was away.

I really have high hopes that Oz will be one of the fortunate cats who goes into remission. I know you're testing a lot right now, but part of the reason for the frequent testing is that he is responding so well to this dose, you're shooting lower numbers than you have before, and we don't really know his patterns yet. When is his usual nadir? How well does he recover from bounces? Etc....This frequent testing is helping us figure out the answers to some of those questions. Once you understand his responses better, you can tailor your testing more to his patterns (although our kitties are notorious for changing their patterns).

I won't lie, though. Going into remission is exhausting. Once Jersey's pancreas kicked in and started producing it's own insulin, I had to step it up on monitoring. I was a walking zombie for about 2 weeks - and I don't feel like I tested as much as I should have at night during that time. Those two weeks were well worth it, though.

I don't know what the exact answer is for you on balancing your own needs and Oz's. Perhaps if you and Erin take "shifts," that can help? My husband and I did that, and the breaks we each got helped a lot. Hopefully others will be along to provide some tips on what has helped them balance diabetes and "regular" life. Regardless of what you come up with for your specific situation, you can't wear yourself out completely. If you do that, you won't be any good to Oz. So, make sure you find a way to take care of yourself. :YMHUG:
 
Hi Ian,

I just saw the 94 on Oz's ss. That's a great, healing number. :mrgreen: You may want to try feeding another tsp. or two of low-carb food. Sometimes feeding just a bit more will help a kitty "surf" the greens (meaning that the numbers flatten out).

Edit: Oops - there's that darn cross-posting again! :-D
 
Thank you Shelly,
I gave him a little food & will re test at +5.

I'm wondering if I'm beginning to understand (from a remission point of view) what I'm doing when giving the insulin.
Is the basic idea that, you give insulin to bring the BG level into a normal range repeatedly, hoping that the pancreas will take over & no longer need the insulin, that's why you want to keep them in a normal range for as long as possible during a cycle?

Ian
 
Yep - if you can keep Oz in the normal range for as long as possible, it gives his pancreas a chance to rest and heal. If it can do that, it may be able to start working again. Thus...no more Lantus needed. :-D
 
Well at +5 he's at 93, so staying around the same Shelly, I guess because of the food, even though it wasn't very much?
His ear has a lump from all of the testing, I'm guessing there's not much you can do when you have to test so much, I think I had read that their ears can handle it but just wondering.

Ian
 
Yep, he has a nice "surf" going right now. Isn't it amazing how just a little bit of food can help them along?

Are you using Neosporin with pain relief for his ears? That stuff works wonders. If you aren't using it, I would highly recommend it; we used it religiously. You can also alternate ears, although I've heard a lot of people say one ear often bleeds better than the other. We paw tested, and we always alternated paws (and location on the paws) for each test. Make sure you hold pressure on the testing site for 20-30 seconds after the test. That will help with bruising.

I have to sign off for a while, but it looks like you're in great shape. If you run into any problems - like numbers under 50, which I don't anticipate at all, you can go back to your very first post here and click on the "911" icon. That will bring immediate attention to what's going on.
 
Hi Ian, Erin, and Oz!

Welcome to Lantus Land. Sorry I missed your first condo in LL yesterday. You are doing great with testing and are asking great questions.

A couple things I'd like to clarify. First, we don't have a "no shoot number" in LL. We do ask that the first time you get a 150 or below or the first time you shoot green, that you stall without feeding and post for help. We have several options to offer you. ;-)

Lantus does do best with consistency but sometimes we need to shoot early or late and are off the 12 hour schedule. As long as you shoot about 30 mins from the previous shot, you're ok....and as long as it isn't every day. So we stick to the 12 hour schedule as much as possible but today, you were 35 mins late this morning so you could have shot on your regular time tonight.

If you get behind more than about 30 mins, then the methods quoted are good. Here's some additional information on Getting Back on Schedule.

Please let me know if you have questions :-D
 
Hi Marje,
Thank you for your reply.
This is all new & overwhelming but I'm determined to do the best I can.
Thank you for the link!

Ian
 
You're welcome. Sorry about the typos. I fixed them. It was late last night :-D

We understand it's overwhelming at first, but within a month (if Oz isn't in remission), you'll go back and read your first posts and realize how far you've come. We are here to help!
 
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