10/30 Jessica AMPS 492

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Ewwww....Icky number for Jessica this morning!!

What concerns me is that she's at such high doses, but since you haven't been letting each dose "settle" for at least 6 cycles, she may not even need that much. (I'll ask for some input from some of the more experienced members too)

Lantus works differently and it's really important to give the same dose each cycle, even though there are going to be days when it looks like she's way high (and seems to need more) or too low to give anything. If she does have a pre-shot under 150, you might want to "stall", don't feed, and retest in 30 minutes (and use that 30 minutes to ask for help)

Let's give the protocol a try and see how she does. :-D
 
Hi guys .. no dosing advice from me but I sure hope jessica finds that breakthrough dose soon and you start seeing lots of green! Have a great day guys!
 
We won't know if 5.5 is too little or too much until you've given it for at least 3 days.

As I've said, you just have to kind of ignore those pre-shot numbers and hold the dose unless Jessica goes too low and "Earns" the reductions. What could have happened is that last night, she went really low, and this morning's high number was a bounce. Bounces happen when the cat's blood glucose goes lower than their body is used to (or drops fast) and their liver sends out hormones and sugars to bring it back up to where it's "used to". They can take up to 72 hours to clear, so it's important to know when they're bouncing, and when they need a higher dose. By keeping the same dose for at least 6 cycles, and testing as much as you can, you'll gradually start to see a picture of how well Jessica is really doing.

Since you've been changing your dose based on that pre-shot number, there's just no way to know at this point if she's going to need more, or less insulin. (because you have been changing doses so often, it IS possible she may even need less)

We are all here to help you and we hope Jessica will do better soon :-D
 
Hi Chris,

Thank you much for your advices. Now, I have more understanding about the Lantus.
Most of the time when Jessica BG level dropp below 100, I'm kind of panic and tend to reduce the dosage for next shot since I'm unable to monitor her during the day time.
Another problem with Jessica is, she won't let me test her BG level and she was hungry. She won't surrender until I gave something to eat.
What I can only do is to test her right after the food. So my next test will be influenced by the food.
Next time, I will keep each dose for 3 days.

By the way, You said "hold the dose unless Jessica goes too low" What number shall I consider as too low?
 
Hi Chris,

Thank you much for your advices. Now, I have more understanding about the Lantus.
Most of the time when Jessica BG level dropp below 100, I'm kind of panic and tend to reduce the dosage for next shot since I'm unable to monitor her during the day time.
Another problem with Jessica is, she won't let me test her BG level and she was hungry. She won't surrender until I gave something to eat.
What I can only do is to test her right after the food. So my next test will be influenced by the food.
Next time, I will keep each dose for 3 days.

By the way, You said "hold the dose unless Jessica goes too low" What number shall I consider as too low?
 
"hold the dose unless Jessica goes too low" What number shall I consider as too low?
Click to expand...

If she drops below 50 at any time, it's an automatic dose reduction, or if she stays in normal numbers (50-130) for a week it's a reduction.

she won't let me test her BG level and she was hungry. She won't surrender until I gave something to eat
Click to expand...

If Jessica gives you trouble during testing, try giving her a little chicken (or freeze dried chicken if she likes it) to keep her "occupied" while you're testing. It will take a little while before food will influence the numbers, so if you can get her to hold still for testing with just a little low carb treat, it's worth trying.

We say don't feed for 2 hours prior to Pre-shot tests (the other tests aren't so important) but if you can't get the pre-shot tests without food, a couple of pieces of chicken while you're poking won't influence the numbers for another 30-60 minutes, and even then, since they're pure protein, shouldn't raise the number much. I think most of us use the "Test/Shoot/Feed" (or test/feed/shoot) method...all in about 15 minutes.

If you get a pre-shot test under 150 and you're not sure what to do, if you can stall, that's great. Don't feed and retest in 30 minutes to see if her number is rising. If it is, go ahead and shoot/feed. If it's not, you can either stall again, skip the shot, or give a BCS (big chicken s***) dose (a smaller dose than you would give if her number was above 150)

The only thing about skipping or doing a BCS dose is that the 6 cycle "clock" starts over
 
Frankie, I'm glad you are going to try to stick to the same dose for a while. Lantus dosing is based on the nadirs, with only a little consideration given to the preshot numbers. Those higher numbers are hard to look at, but what's really important is how low Jessica is getting on any dose. Since you are using the SLGS method, the deduction point is 90. When her lowest BG is below 90, you reduce the dose by .25U.

Lantus is a depot insulin which means the insulin is slowly absorbed by the body and impacts more than the current cycle. Because of that, we try to stick to the same dose for at least 6 cycles, unless Jessica earns a deduction. Changing the dose too often can produce wonky numbers.

Since you shot 5.75 today, why don't you try sticking with that same dose for at least 3 days. The SLGS protocol actually says to stick to it for a week. Unless of course Frankie goes under 90 in which case you'd reduce to 5.5
 
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