10/19/2014 DOSE ADVICE 122 +4 114 +6 125 +9 160 PMPS 222 AT

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Cindywith4cutecats

Cindywith4cutecats

Member Since 2014
I changed Normans dose to .50 of Lantus after last night him going to low so fast. This morning PMPS being 122 so close to the PMPS 124 last night . We went .50 rather than reducing by .25 because of FEAR. figured I could add back if I needed but to tough to take away. He has been acting great and we have errands to run so I didn't want to shoot low and then not be home for 2 hours today and leave him alone.

Link to yesterday and why I changed his dose ....viewtopic.php?f=9&t=127162
 
Re: Norman PMPS 122 +4 114 +6 125 changed dose this morning

Glad to see you opened a new thread. This is your daily condo. You open a new one each day and add today's date in your subject line. That way you can keep everything for Norman that day in one place.

The reason Julie had also mentioned how important it is that keeping it all on board in one place, is so there is not a chance of advice being given with missing or fragmented information. If someone comments without all the pieces, you may get skewed advice that is different than it otherwise would have been. This way it is a continuous conversation with all going on with Norman that day together chronologically. And makes it easier for you to understand too when not as all over the place. This board is peer reviewed, FB is not. There are many experienced folks here to guide you and it will become clear quickly who those are. Look to see how long they have been members, how many posts they have made, etc.. People will get to know Norman's patterns and be watching for you.
When you open your new condo add a link to his condo from yesterday. That way at any point in time someone who is maybe not familiar with him or has been off board a few days, can come to Norman’s thread and click backward and catch up chronologically in in a matter of a few clicks before giving advice.


I saw you dropped Norma’s dose from 1U to ½ U. I am not sure why?? Per the protocol you would have only lowered the dose down if he had gone below 68 on ALPHATRACK in the previous cycle. And IF that had occurred, you would have only adjusted down by 1/4 U not 1/2. I don't want you to jinx his great progress. That is why I was pushing for you to get over here to Lantus Land for guidance so you weren't punting and randomly making changes on your own. Let's see what folks think you should do now since you already jumped ahead this morning. It won't hurt for one cycle I am sure. But let's see what should be done for the next shot this eve.
 
Re: Norman PMPS 122 +4 114 +6 125 changed dose this morning

A couple of other comments. Are you leaving food for Norman when you leave the house. For my kitty, I learned mini meals were best and fed him small amounts 6-8 times per day. This works well for lots of FD kitties as it is easier on their pancreas. So leave a little canned food down for him if you leave the house. As long as it is not within 2 hours before pre-shot test time, you can feed him a little bit spread out all day. Add some water, a teaspoon or 2 to each serving. It is a great way to get more moisture in them plus food stays fresher longer without getting dried up. You can also make catsicles..mix a can of food with 40% or so water and freeze like ice cubes. Pop these out to tide them over during the day, overnight when you have to leave the house, etc..
This would also be great for when hubby is watching and you are away. I used to leave a serving or 2 that is ready to eat now, plus a catsicle or 2 for later depending on how long you will be gone. These usually thaw in a couple of hours.
 
Re: Norman PMPS 122 +4 114 +6 125 changed dose this morning

Julie posted while I was typing. Good suggestion for you to read to help understand the way Lantus works
Also be sure to review the 'New to the Group...
and 'Tight regulation Protocol' stickies at top of forum.

It will help explain dosing and when to change/not to change. But it does take time to absorb it all I know, so UNTIL then PLEASE post here for help before making dosing changes so we keep Norman on the right track.
 
Re: Norman PMPS 122 +4 114 +6 125 +9 160

Ok I totally messed up. His +9 160 makes me scared. I dropped to .5 because I was just scared of him turning to low even a .75 dose. Now at +12 I am trying to figure out, go back to dose I know works which is 1 unit or try .75 dose. If I understand any of this which you can tell I am hanging on by a thread I would believe he would call for his dose that worked at 1 unit.
 
Re: Norman PMPS 122 +4 114 +6 125 +9 160

Post for advice for your next dose. Don't punt!!!!! Add something like ...'dose advice' and use the ? icon. And be sure to add AT in your subject line. (short for alphatrack) You may need to drop the first couple BG numbers off if you need space. This will give you time for some advisers to peek in before your shot is due since Sundays can be slow around here sometimes... but you have a few hours before your shot.

ETA:
Don't worry its not a big deal. You didn't ruin anything- just skipped ahead a little fast. He still has great #s. But there was a reason we wanted you posting here... you were getting piecy advice from a million directions. Can be confusing. For now I would suggest you post for clarification especially regarding dosing changes here before you make them. Don't worry about trying to figure it all out at once just ASK for help first. You will understand the bigger picture in time..it took all of us time.
People will alter their dose for reasons other than following the protocol, sometimes it is like you said, you have to be gone all day or such..But what happens is you keep testing and entering your data and patterns begin to emerge on how YOUR cat reacts. SO then you have data that allows you to feel more comfortable and not have to worry if you need to leave. If they are too low at shot time to shoot there are 3 options from you to choose that are spelled out. Just keep reading the starred stickies over and over. It will mean more when you actually get to those points. But ultimately don't worry about whether you understand every detail right this second. Tons of experienced people here will help you when you hit each step. In time you will start to understand and know what to do on your own.
Hang tight and let's see who comes around with dosing advice for your shot tonight. Technically you would have stuck with your same dose from yesterday this morning. But now that you have dropped, I'd rather get some more feedback on what to do for tonight.

And do read up on the depot as Julie suggested. This may not even cause a blip today but could instead be in the next day or so. No big deal regardless. You just figure out what to do for the next one and keep moving. He's doing great!! Anyone would want these #'s
 
Re: Norman PMPS 122 +4 114 +6 125 +9 160

HI Cindy!!

Do us a favor and add today's date to your subject line...just helps us keep things straight...and your morning test is the AMPS (AM Pre-Shot)...your evening test before shooting is the PMPS (PM Pre-shot)

Today's subject line should read 10/19 Norman AMPS 122,+4 114,+6 125,+9 160 AT

Lantus has a protocol that we use...I believe I've told you before that we make them EARN reductions ...they earn them by dropping below 68 (on the AlphaTrak) so unless you're unable to test or don't have the supplies you need, it's important to give the SAME dose every 12 hours unless he earns that reduction.

I know it sounds scary when you see that 1 unit drops them from 200 to 80....you think "OMG! If I shoot 1 unit and he's only at 120, he'll drop to ZERO!!"...It doesn't work that way....LOL

This is from the protocol we use (that's most successful getting kitties OTJ) The BLUE is mine to highlight the 2 parts most relevant to you right now. Holding and reducing dose

"General" Guidelines:
Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).
Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).
Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.

Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.

Reducing the dose:
If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. SINCE YOU USE THE ALPHATRAK AND HE'S A NEWLY DIAGNOSED DIABETIC, HE EARNS REDUCTIONS OF .25 UNIT WHEN HE DROPS BELOW 68. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. See additional notes in the next paragraph about drops into the 20s and 30s. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.
Click to expand...
 
Re: 10/19/2014 Norman AMPS 122 +4 114 +6 125 +9 160

The other way kitties earn reductions is to stay in normal numbers for 7 days....That's how we gradually get them OTJ!

Either they drop below 68 and keep earning reductions until they're in normal numbers without any insulin OR

They hold in normal numbers at the same dose for at least 7 days...then we'll try reducing .25 unit and see if they can maintain those normal numbers....if they CAN, then after a week, we drop it another .25 until they're at .1 unit....Hold that for 7 days and if he's still in normal numbers, it's time to do an OTJ trial!

Or it can be a mix of the two....LOL Isn't this fun??

(Just FYI...you don't need to put the year into the subject line...you may need that space later for other test results)
 
Re: 10/19/2014 Norman AMPS 122 +4 114 +6 125 +9 160 AT

CIndy-

If it were me, I would add ...dose advice? in subject.

the board can be slow on Sunday and that will get eyes and attention if some advisers pop on between now and then. That way you will not get stcuk at the last second if no one is around. You still want to come back with your number before his pre-shot...but this way you may get some feedback ahead of time from some of the others.



Also, when you get a chance, read through some of the other kitties condos. I learned so much that way. Inevitably you will be dealing with some similar scenario with your own kitty at some point,and you will recall..oh yeah!

PS: I weened Hank off by drops..over weeks. We went down a 1/4 at time then by drops until there was no place to go. They practically had to grab the needles out of my hand. It was harder taking him off than when he got on. I was worried about his OTJ sticking and wanted to give his body as much support and time possible it needed to heal. And it did stick...he was diet controlled from then on.
 
Re: 10/19/2014 DOSE ADVICE 122 +4 114 +6 125 +9 160 PMPS 22

AMPS 122 +4 114 +6 125 +9 160 PMPS 222 ALPHATRAK METER....dose advice. I goofed by lowering him to .50 dose from his 1 unit. If you see that yesterday he had gone down quick on me. Here is his link from last night ...viewtopic.php?f=9&t=127162 ....If I am correct I would think we need to go back to dose we know works ( 1 unit ).
 
Re: 10/19/2014 DOSE ADVICE 122 +4 114 +6 125 +9 160 PMPS 22

Yes, I'd go back up to 1 unit and hold it unless he drops below 68

Another hint....if you have a question, edit that first subject line to add the ? icon to it....Once your question is answered, you can remove it...then later in the day if you have another question, you put it back up

The people that skim the forums for problems look for those ? icons to check out first
 
Re: 10/19/2014 DOSE ADVICE 122 +4 114 +6 125 +9 160 PMPS 22

thank you Chris and China. I feel so much better . I hate seeing these HIGH numbers. He was doing so good and then I freaked out. I have got to learn to ride it out and surf him with food if he should drop lower than needed. Thank you for you time.
 
Re: 10/19/2014 DOSE ADVICE 122 +4 114 +6 125 +9 160 PMPS 22

i don't think your reduced dose this morning caused the 160, cindy, or the 222 at pmps. it is ok to reduce the dose when you know you can't monitor and you're worried about his safety - that's called being smart. It's better to have him go a little high for a while than for him to go too low with no one home.

for a little perspective - 160AT is still in the normal blood sugar range, so it's ok. Blood sugar fluctuates - you're more aware of it because you're testing more, but it's been doing this all along.


Betty's advice about food is good. I had to go back to work while punkin was diabetic and we got a timed feeder, the PetSafe 5 compartment feeder to help while my husband and I were at work. We always fed him at +3, so we began putting all of his +3 meals into the feeder. Then when he was used to eating from there, and I was headed back to work, we could be confident punkin would eat while no one was home. If we got a low preshot in the morning, we'd set times on the feeder for it to open and put food in all 4 covered compartments.

If a cat goes into low numbers, the first tool we use is food. So if you've got food available and you have practiced so you know Norman will eat from the feeder, that can give you a measure of safety. Punkin's nadirs were usually around +5.5, so we'd set the feeder to open at +3 for his regular mini-meal (1.5oz food), then have it open at +4, +4.5, +5, for example, so that we knew he was getting food to sustain his blood sugar from going low.

With both a timed feeder or catsickles, you want to practice when you're home so you are confident he'll eat them when it counts. Having a back-up plan for feeding can give you a little more flexibility in life.

If Normal keeps going up with your next test this evening, I'm going to think that he's bouncing. Read the second post in that link to get an explanation of it.

we do have a saying here - "this is a marathon, not a sprint." As you understand more you won't be as easily freaked out. Everyone does it at the beginning, though - you're in good company and we all get it! While Norman looks like he's doing well, it will still help you if you think of this as a marathon - gear yourself up for doing it for a while. :-D
 
Re: 10/19/2014 DOSE ADVICE 122 +4 114 +6 125 +9 160 PMPS 22

You've gotten great advice and info so far, so I just want to say to LantusLand! This is the BEST place for technical help and moral support. Keep posting questions. As Julie said, we've all had our freak out and melt down moments...you are among those who understand!
 
Re: 10/19/2014 DOSE ADVICE 122 +4 114 +6 125 +9 160 PMPS 22

Just a quick update. Normans AMPS 145. He received his 1 unit Lantus and is frisky this morning. trying to use the feeder for all his upcoming feedings to make sure. I have a call into the vet to see if he can a quarter tab of 20mg Pepsid AC....The clavimox has made him throw up here and there. He threw up 3 hours after insulin so I was freaking but after about 20 minutes his tummy calmed down and he ate AGAIN. I know with the Pepsid AC he would have to take at least 2 hours before or min two hours after the Clavimox otherwise it would interfere with absorbtion
 
Re: 10/19/2014 DOSE ADVICE 122 +4 114 +6 125 +9 160 PMPS 22

Cindy-

You want to open a NEW condo each day. Start your SUBJECT line by posting the date, then his BG number.
Then you add a link to the previous days thread at the top of the TEXT part of your condo.

That way you keep all Normans information for EACH day in one place and it's own continuous thread.
If you need to ask a question you can add the ? icon when you post, or edit your subject line to add something at end.

If someone is checking condos for anyone who may need a quick response, dosing advice, etc..they will be skimming the subject lines first so that way you catch their eye.

Otherwise, for updates, information, questions that are not urgent, etc..you would just post in your same condo for THAT day...and check back for replies.
This is Norman's condo on the board- and where people come to visit and check on him.

I was looking for ya'll then found your thread from yesterday with a new post at bottom but it was buried.
I think 1/4 of a 20m Pecid AC sounds like a lot. Isn't is 1/4 of a 10m we are supposed to give? Hopefully someone else will chime in as I didn't give these much.
 
Re: 10/19/2014 DOSE ADVICE 122 +4 114 +6 125 +9 160 PMPS 22

There are exceptions (like my Trix), but yes...usually you start with 1/4 of a 10mg Pepcid AC, or 2.5mg Pepcid, once a day. I don't have any experience with giving Pepcid along with ABs, so I can't speak to the timing issue. With vomiting, the Pepcid might not be the right answer, though. For nausea and vomiting, cerenia or ondansetron are usually the meds of choice.
 
Re: 10/19/2014 DOSE ADVICE 122 +4 114 +6 125 +9 160 PMPS 22

Welcome to LL. You might want to try a probiotic like Country Life Acidophilus from the health food store to help while on antibiotics. You can use it too should you need to take antibiotics as it can help with stomach upset. You would just put a little in with the food a few times a day. It can really help.
 
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