11/7-Cini Mini PMPS/196 - I gave him 1 Unit

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Re: 11/7 - Cini Mini - AMPS 271 - Gave .50 units

good morning cathy!

just curious - what made you reduce his dose last night? here are the guidelines from 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.

Reducing the dose:
If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. 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. 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.
If an attempted reduction fails, go right back up to the last good dose.
Try to go from 0.25u to 0.1u before stopping insulin completely.

Random Notes:
Because of the cumulative nature of Lantus and Levemir:
An early shot = a dose increase.
A late shot = a dose reduction.
A "cycle" refers to the period of time between shots. There are 2 cycles in one day when shooting twice a day.
Sometimes a dose will need to be "fine tuned" by adding some "fat" or "skinny-ing up" the dose.
Click to expand...

Reducing the dose by 50% is too much. He needs to hit 49 or below to reduce, and then you would reduce it by .25 - so your new dose would be .75u. Cini Mini is looking really good, but you're going to get the best results if you follow the protocol. It's in one of the yellow starred "stickies" at the top of the Lantus forum.

The goal is to keep our cats as much as possible in the 50-120 range, so the 72 that cini mini got to yesterday was just awesome. You don't want to hurry him out of that range, you want him to spend as much time as possible in it. Next time he gets lower, just let him be there and wait to give high carbs until he gets below 50. his body has gotten accustomed to higher blood sugar levels and he needs to get re-accustomed to the lower numbers.

there's a ton to learn on this diabetes dance!
 
Re: 11/7 - Cini Mini - AMPS 271 - Gave .50 units

Hi Julie.

I was going according to what was in the "Shooting and Handling Low Numbers" sticky

Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?

A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines. Below 150 mg/dl (8.3 mmol/L), don't give insulin. Between 150 and 200 (8.3-11.1 mmol/L), you have three options: a.) give nothing; b.) give a token dose (10-25% of the usual dose); c.) feed as usual, test in a couple of hours, and make a decision based on that value. Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.
Click to expand...

Will I ever get the hang of this? ohmygod_smile Now what do I do tonight? Increase to .75 units?
 
Re: 11/7 - Cini Mini - AMPS 271 - Gave .50 units

ah, ok. yeah, i've noticed there are some inconsistencies around. you're not the only one to get caught on that one. i think that's basically for newbies who aren't getting help. you're doing a great job of getting tests in.

i'm not certain what the best thing is to do tonight - let me get some more experienced people to advise you on it.

certainly, no beating yourself up!!!! really. you're doing fine and the joyous thing about this sugar dance is you get to try again every 12 hours! :lol:
 
Re: 11/7 - Cini Mini - AMPS 271 - Gave .50 units

ok, brain wasn't in gear yet. i need a little more caffeine.

just edit your first post of this condo and put "dose advice?" in your subject line - that'll get eyes on it from whoever is available. lots of time before you shoot tonight.

and really, don't worry about it. it's all fine. always better to shoot too little and be safe than to shoot too much. you can't take it back out. so no worries.
 
Re: 11/7 - Cini Mini - AMPS 271 - Gave .50 units

Hi guys .. don't worry, you'll get the hang of this .. You are doing great and cini mini's looking good! Hope you guys have a great day!
 
Re: 11/7-Cini Mini - AMPS 271, +2/258 - Dose advice for toni

Hey look - his +2 was 258, that's good right? It's not that far from his AMPS of 271. confused_cat
 
Re: 11/7-Cini Mini - AMPS 271, +2/258 - Dose advice for toni

If you read down a little further, the general guidelines (i.e., A4.4) is relevant to the "start low, go slow" approach. We don't generally follow that here. We follow the Tight Regulation Protocol. As such, we use 150 as the 'whether to shoot' number. It also means that when you reduce a dose because of a low pre-shot number, no matter which protocol you're using, you bring the dose up to your usual amount the next cycle unless numbers dropped below 50 (for a cat that's within a year of diagnosis).

Right now, I think you're seeing numbers that are all over the place because you're not shooting consistently. FWIW, I'd bring the dose back to 1.0u. You were beginning to see blues and greens on that dose.
 
Re: 11/7-Cini Mini-AMPS 271,+2/258,+3/212 - Advice for tonig

Hi Sienne, guess I got a little jumpy with the double digit numbers. I will definitely try harder next time to not panic at 72, lol

I'm just so hypersensitive right now about Cini since he came home from the emergency vet two weeks ago.
 
Re: 11/7-Cini Mini-AMPS 271,+2/258,+3/212 - Advice for tonig

YOU'RE DOING GREAT!

It's hard not to sweat the low numbers...
 
Re: 11/7-Cini Mini +5/170, +7/221,+9/230 - Advice for tonigh

OK, I am thinking .75 units for tonight. Knowing me it'll probably be closer to 1 unit since I can't see those little hash marks too well. @-)
 
Re: 11/7-Cini Mini +5/170, +7/221,+9/230 - Advice for tonigh

Cathy:

I definitely agree with Sienne that you should be shooting 1u tonight......
 
Re: 11/7-Cini Mini +5/170, +7/221,+9/230 - Advice for tonigh

Because I'm a chicken and if I give him 1 unit tonight at 11pm I'll be in bed and won't know if he goes too low too fast?
 
OK, so I took a leap of faith and went ahead and gave 1 unit of Lantus. I'll make sure to get a BG some time tonight when I wake up to give him more food in his bowl.

I can't wait till he's back on an 8am / 8pm schedule. I'd feel so much better about getting a +2 reading before I go to bed.

Funny story - I came upstairs to look for him so I could do his BG and he was in the middle of the floor with his cat bed on top of him, walking around like he was wearing it like a hat. What a goonybird, LOL ohmygod_smile
 
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