? 11/27 Drastic drop in BG

[Molly and Sammy]

I've been very frustrated that two months in, my Sammy's numbers are still terribly high. Last dosage change up to 3.5 Lantus 2X daily about a week ago. I've pretty much been following SLGS with some tweaks due to vet advice - she is great and loves that I am using this forum for education and advice. I had gotten too many fur shots lately, (and I do know how to tell, and have noted them on the SS) and also read that sometimes injecting in the exact same spot can alter absorption. Last night and this morning I sort of tipped him in a very different position and it FELT like the Lantus penetrated in a different way. I know that sounds crazy, but it did. This morning I got another ugly number, 503 (Alpha Track) shot him, and got another test at +4. It was 292! Super low for him at any time. He disappeared under the bed for his siesta, and I just lured him out at +8 and got 149! Tested again and got 147, then tested myself in case my meter is wonky and mine was its usual reading. So. For whatever reason we seem to be in a whole new game here. How do I proceed? My vet has said for now don't shoot under 250 on AT. But if he is suddenly somehow getting a big jolt he had not been receiving, should I drop his dose back even if it is over 250 at PMPS? Thanks so much for being there.

 

[Wendy&Neko]

Hello and welcome. Good catch on this blues today. Since you are following SLGS, you would reduce if he went below 90, which he didn’t. And SLGS says to hold the same dose if you see a number between 90 and 150, which you did. Your increases have not been per SLGS, which only increases by 0.25 units at a time. Can you tell us what other “tweaks” your vet has suggested? The size of increase we use is for safety.

On FDMB, we use 200 as the no shoot number for newbies. You have seen what skipping, ie fur shots, can do to his numbers. If you are around to monitor tonight, I would lower his no shot number. It’s likely he will be over 200 by shot time.

 

[Molly and Sammy]

Wendy, thank you. The vet wanted all increases to be a full unit, starting those one times a day before increasing and to hold for at least a week. So if I am understanding you, you suggest I base changes only on today's scores, not worrying that he may have been getting less than I intended recently. What happened today on 3.5 is what counts, and I should shoot 3.5 tonite if PMPS is over 200 Alpha Track. Correct? Thanks again.

 

[Chris & China (GA)]

not worrying that he may have been getting less than I intended recently.

There's no way to know how much of each shot might have gone in, so all we really can do is base it on what we know for sure.

I should shoot 3.5 tonite if PMPS is over 200 Alpha Track. Correct?

Correct....and try to get at least a couple tests in tonight. Getting a +2 is usually a good test to get because it can usually give you a good idea of what might happen later in the cycle.

 

[Wendy&Neko]

Cats are very sensitive to small changes in dose. Which is why we increase in smaller amounts, to not bypass a good dose. It is very common for vets to want bigger increases than what we do here.

Fur shots do impact the depot, so today’s numbers might have been lower if you hadn’t done that last fur shot. But we dose based on what we see, not what might have been. When deciding what to do with a dose, we look at all cycles on that dose,with the exception that if you see a 90, you decrease by 0.25 units on the next shot.

 

[Molly and Sammy]

There's no way to know how much of each shot might have gone in, so all we really can do is base it on what we knknow.

Thanks so much. I'm getting some conflicting advice, of course, including dropping him to 1.5 and starting over. I appreciate all the help, will see where he is at shot time and go from there. And yes, will get a +2 and +3 tonight.


Correct....and try to get at least a couple tests in tonight. Getting a +2 is usually a good test to get because it can usually give you a good idea of what might happen later in the cycle.

 

[Molly and Sammy]

Cats are very sensitive to small changes in dose. Which is why we increase in smaller amounts, to not bypass a good dose. It is very common for vets to want bigger increases than what we do here.

Fur shots do impact the depot, so today’s numbers might have been lower if you hadn’t done that last fur shot. But we dose based on what we see, not what might have been. When deciding what to do with a dose, we look at all cycles on that dose,with the exception that if you see a 90, you decrease by 0.25 units on the next shot.

drop

So you'd leave the dose at 3.5 tonight.Another person suggested I drop to 1.5 and start over. Thanks!

 

[Chris & China (GA)]

So you'd leave the dose at 3.5 tonight

Yes....stick with the 3.5

I don't know who's telling you to drop back to 1.5, but usually what happens when you "start over" like that is you just end up wasting a lot of time working your way back up while your cat develops glucose toxicity....and then you end up on an even higher dose to break through that

If the 3.5 really is too much, getting several tests during the cycles will tell you.

 

[Molly and Sammy]

Yes....stick with the 3.5

I don't know who's telling you to drop back to 1.5, but usually what happens when you "start over" like that is you just end up wasting a lot of time working your way back up while your cat develops glucose toxicity....and then you end up on an even higher dose to break through that

If the 3.5 really is too much, getting several tests during the cycles will tell you.

Thanks, Chris. I see the logic in your advice. It is such a gift to have you folks to turn to!