11/20 SUMO PMPS 224 +1 297 +2 381

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Mary and Sumo

Mary and Sumo

Member Since 2011
Hello, New to Lantus as of 10 days ago. I did a curve both yesterday and today. Sumo has been on the 1.5 unit dose x 4 doses. At his PMPS his number is lower than his +9 and not sure how to handle. I don't think I shoot if his numbers are still coming down right? He is due for his 6:15pm dose in just a few minutes. How should I proceed ??

AMPS 339
+4 294
+6 305
+8 226
+9 230
PMPS 189
 
Re: SUMO's Curve today-Dosing advice needed NOW !

Looking at your SS. How long can you stall and still be ok? When we stall, we have to make it up in either 15 min increment with each cycle till you are back on time or 30 mins once a day.

Do you have lots of strips, HC food/gravy, karo?

BRB.
 
Re: SUMO's Curve today-Dosing advice needed NOW !

I have all of gear for testing and God forbid a Hypo, but by waiting means delaying his AM dose tomorrow right ?
 
Re: SUMO's Curve today-Dosing advice needed NOW !

In addition to the questions that Marje asked, can you stay up to monitor tonight? the very minimum will be a +1 and +2.
 
Re: SUMO's Curve today-Dosing advice needed NOW !

It means stalling his PM dose....did you already give it and if so, what dose?
 
Re: SUMO's Curve today-Dosing advice needed NOW !

Hi Mary, welcome to Lantus Land. Sumo is a beautiful kitty. Marje gives excellent advice so you are in good hands. Don't forget to breathe. :smile:
Liz, Zener's other bean
ETA: so does Sienne. :smile:
 
Re: SUMO's Curve today-Dosing advice needed NOW !

Just curious....did someone in LL suggest you raise him to 1.5u without more testing to see if he was getting low and bouncing back up?

When you get a low PS you have three choices:
1. for this number, shoot the regular dose on time and then be sure you get at least a +1 and +2 to see which way he's going

2. do not feed, stall, checking every 15-20 mins and shooting the regular dose as soon as you get a rise

3. shoot a reduced dose on time; but the shed may keep his numbers coming down so you still have to monitor

4. skip

with this number, door number 4 is my least favorite option

ETA: you haven't fed him right???
 
Re: SUMO's Curve today-Dosing advice needed NOW !

My vet wanted to view his SS after 1 week on the 1 unit. I followed her instruction. I think retesting every 15-20 min is the way to go here.
 
Re: SUMO's Curve today-Dosing advice needed NOW !

Ok....you can stall and recheck every 15-20 mins if that is what you are most comfy doing. This is a totally safe number to shoot, though, and we will encourage you to learn to start shooting a little lower each time. Also keep in mind that with meter variance, he's not that much down from his +9. It is a little over the 20% variance, but not a lot so he hasn't dropped much.

Alright...do not feed him. Look for the rise and as soon as he starts coming up (and he may come up fast), you want to shoot and feed. Then please be sure you get a +1 and +2 and post. What we want to do by catching him as he rises is take advantage of any overlap of cycles so don't let him get too high since onset takes a couple of hours.

Then when you need to make up the time, you can do it, as I said, by shooting early 15 mins each cycle starting tomorrow a.m. until you are back on your regular time OR 30 mins once a day starting tomorrow night.

I want to give you some info about the protocol but let me post this so you can read the instructions and then I'll send you the other info.
 
Re: SUMO's Curve today-Dosing advice needed NOW !

No I have not fed. +12.5 is 181 I will continue checking every 15-20 and repost.
Thank You, Mary
 
Re: SUMO's Curve today-Dosing advice needed NOW !

Great....you can change your subject line to record those numbers and look like this:

11/20 Sumo +12 189 +12.5 181

that way we know at a glance what he's doing. Just keep adding them as you get them. To change the subject line, just go back to your first post of the day, click "edit", change the subject line, and then click "submit".

Also, we only use the term "PMPS" if you shot. If you haven't shot, you just use the # of hours since the last shot. If you skip, you use "PMBG" or "AMBG" if it's in the morning.

Good job!! Most newbies feed while stalling :roll: :roll: so great that you didn't!!

And like Liz said "bbreeeaaathhhheee!!" :-D :-D
 
Re: SUMO's Curve today-Dosing advice needed NOW !

While you are stalling, a few quick points:

--in my signature block, you will see links to "Dealing with Low Preshots" and "How to Handle Low Numbers"; it's really good if you print those, study them, and keep them on hand where you can get to them just in case no one is
up to guide you through it.

--in accordance with the protocol

"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.
•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.
Click to expand...

You did hold the intial dose just fine but I, personally, don't think you had enough data to know what his nadir was to increase it by .5u. We try to take it slower so you don't miss his fitting dose. Alot of vets want to dose on the preshot number and not the nadir and that can result in a kitty becoming overdosed. We like to see you get some mid-cycle tests so we know what his nadir is as kitties can quickly come down and shoot back up again so we don't assume that just because he was in the 300s at AMPS and again at PMPS, that he stayed there. Great that you did the curves but if he got low before and is in a bounce, you would expect these kinds of numbers.

Will you be able to test more mid cycle during the week?
 
Re: SUMO's Curve today-Dosing advice needed NOW !

I am very impressed that you didn't feed while stalling! We did that 3 or 4 times before we finally figured it out. :lol: :lol: I agree with what Marje says about most vets don't know how to deal with Lantus. They don't live with a diabetic cat 24/7 like everyone here does and they don't know the protocol. They don't know what to do when you are faced with a low preshot value and wouldn't be available to guide you along in the process of several hours of testing, even if they did know. The advice you will get from the experts and others here in invaluable in keeping Sumo as healthy as possible. And the advice is about much more than dosing. I am constantly amazed at the information on different medications, how to get a cat to eat, litter box issues, food quality of just about every brand and flavor on the market, any and all medical conditions a cat could have, cat toys, meters and strips, where to buy stuff for the best price, and other things that I can't think of right now. In other words, everyone here is as crazy about their cats as we are about ours. It sure it nice to be normal. :lol: :lol:
Liz
 
Re: 11/20 SUMO +12 189 +12.5 181 +12.75 224

I think you can shoot the 1.5u. Please get a +1 and +2.

You ok with that??? :-D

ETA: And Liz, dear. Thanks for the vote of confidence!! ;-) :-D :-D :-D
 
Re: 11/20 SUMO +12 189 +12.5 181 +12.75 224

Mary...you still there? Waiting to see what you did....

If you shot, can you please tell me what time so I can check back on you in an hour? Thanks!!
 
Re: 11/20 SUMO +12 189 +12.5 181 +12.75 224

Marje, you are welcome. You have more than earned it, no question. Mary, you're doing a super job. Sumo is lucky to have you as his bean.
Liz
 
Re: 11/20 SUMO +12 189 +12.5 181 +12.75 224

Oh my goodness Marjorie, I got so busy with Sumo trying to get his dose in that I forgot to post. YES, I shot 30 min ago with 1.5 and have set my timer to recheck for a +1 Thanks for helping out here. I was little unsure and was beyond excited to see your quick response !!!
Thank You, Mary and Sumo

PS I will post with new number
 
Re: 11/20 SUMO +12 189 +12.5 181 +12.75 224

Good...you shot 30 minutes ago? I'll check back in 30......want to grab some dinner but was waiting for your post as to whether you shot.

Yes...that would be great to change your subject line to show his PMPS. Great job!!!!
 
Re: 11/20 SUMO PMPS 224

Mary:

You should have his test numbers on his SS instead of in the "remarks" so people can see them. What you want to do is go under +11 and just put "189 @ 12; 181 @ 12.5" and then under the PMPS column put his number as you have done and then when you shot it "224 @ 12.75".

Have a +1 yet?
 
Re: 11/20 SUMO PMPS 224

Sumo's +1 PMPS was 297. He ate really well. How do I report this? PMPS +1 (or just +1) I have never gone over the 12hr reading. I will follow up with a +2.
Thanks, Mary
 
Re: 11/20 SUMO PMPS 224 +1 297

Just put it under the "+1" column on your SS.

I'll be back in one hour to check on you. This is good!! Nice work.
 
Re: 11/20 SUMO PMPS 224 +1 297

Hi Marjorie I tried and my Husband tried to adjust the SS exactly how you suggested, but we kept getting an error message. So for right now, we thought the "remarks area "was the best choice until we can get it figured out. I posted his +1 a few minutes ago.
 
Re: 11/20 SUMO PMPS 224 +1 297

Mary:

If you click on Gracie's SS, up at the top, click on "Lantus SS" and scroll down to 11/20/10. You'll see how to do the columns. You'll have to reduce the font to get the numbers in there. I am not sure
why it would give you an error???

Waiting for your +2 :-D
 
Hello, +2 381 WOW ! My little brain thinks the food has alot to do with this number, but I know you REALLY know the dynamics going on here! I appreciate your concern and mostly your knowledge helping me in this first time situation. I am guessing I will see some high numbers tomorrow from this low reading today, but maybe, just maybe, he won't bounce. I will continue to check more +'s this PM and post if needed.
Thanks Again, Mary
 
This could be a food spike but it's a pretty huge one. He may already be bouncing from the lower number earlier as you suggested.

You can give him a break and do a +4 and if he's still high, you can probably call it a night and save a strip.

Good luck and you are very welcome.
 
I agree: WOW. They can really zoom. Good job tonight. It's pretty nerve wracking to see lower numbers than you're used to. You handled it all very well. Hopefully you'll get used to lower numbers soon.
Liz
 
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