10/14 Blizzard PMPS 106 Stalling

H

Hilary B

Member Since 2021
My 15 year old boy was diagnosed two weeks ago. He is on .5 units of Lantus every 12 hrs. He’s only been on Lantus for about a week. His preshot numbers have been lower than I’d like. I’ve read up on TR and gathered some data. Looking for some advice.
 
Do you have any specific questions?

I'm assuming you mean you read the dosing sticky. When first starting, it does recommend if you get a preshot lower than 200 mg/dL (11.2 mmol) to stall without feeding and post here for help. What times are your shot times, including time zone? Chances are there will be people around to help guide.you if uncomfortable.

His numbers actually look really good, especially for a newly diagnosed cat and at such a low dose!
 
Hey there! Thanks for getting back to me! He seems to have much lower numbers at PSPM than PSAM. Is that normal? How long should I stall for? Until he gets to 11 mmol? I shot last night at 7.7. Do you think that was too low to shoot at? I'm just wondering if he gets such low pre-shot numbers continuously in the future should I decrease his dose to .25? Not sure I can accurately do that on a syringe! Thanks in advance.
 
How off schedule can you be? Will you be able to monitor tonight as late as needed? Did you switch from dry food or from a higher carb canned? It’s very common for cats to be lower at night. There’s many pj parties here.
 
His PMPS is 5.9. I usually shoot at 8:30 MST. I'm on maternity leave so can be flexible with my schedule. He is on Fancy Feast pates.
 
You haven’t shot this low. Stall. Don’t feed and test in 30 minutes. While you are wait please change your subject bar to our format.

10/14 Blizzard PMPS 106 Stalling
 
Have you tested? Did you shoot ? It’s getting late for you and if he’s not going up he might go a lot lower without food. Please let me know whether you shot.
 
I haven't shot yet. It's now been 13 hrs since his last shot. He has only had a few small pieces of dehydrated liver (as treats for testing).
 
K I'll shoot. I'll keep you posted. I think he should be fine. His numbers are increasing and he is very hungry. Do you think there's a possibility that his dose is too high? This is the second night he's had low preshot numbers.
 
Hilary B said:
K I'll shoot. I'll keep you posted. I think he should be fine. His numbers are increasing and he is very hungry.
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Get a test at +1 and +2 and post here. He might just head up. Let's see.

Hilary B said:
Do you think there's a possibility that his dose is too high? This is the second night he's had low preshot numbers.
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Hard to tell yet. It would be good to get at least one test per cycle to see how low he is going.
I would suggest you shoot if you can monitor and let him earn a reduction by dropping below 2.8.
 
Hilary B said:
I've tested quite a bit. Here is the data I have so far: https://docs.google.com/spreadsheet..._7e65mqh7jerN9OlHr9Aem0pevHK6t6Ua_t-elw#gid=5
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Yes, I saw your SS linked in your signature. I was suggesting getting a test every day (if possible) between shots to see how low he is going.

He could start high and dip pretty low - like you saw on 10/5. A high preshot is not an indicator that he will stay high through the day/night. The idea with getting mid-cycle tests is to see how low he is going on a dose. Lantus dosing is based on nadirs. If he dips below 2.8, the dose is too high for him.
 
Hilary B said:
Is it ok to have a nadir in the 4's mmol? What should an optimal nadir number be?
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Yes. The range for normal blood sugar for a cat is 2.8 to 5.5 mmol on a human meter. A cat is said to be in remission when it can stay in those numbers without insulin.
Our aim is to keep the cat at a dose where it spends it's time in green - that's when the pancreas heal.
 
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