12/08 Tubby AMPS 307 +1.5 241 + 3 175 +4 151 +5.5 134 + 8 69
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Laurie and Mr Tinkles
Member Since 2010
Re: 12/08 Tubby AMPS 307 +1.5 241 + 3 175 +4 151 +5.5 134 +
Shawn, I'm confused. You shot 3.0u last night, because you were worried about Tubby going low and you falling asleep...I understand that. Then you shot 3.5u 4 hours early today? I'm not understanding your thought process....
I thought you were planning on either staying with 4 units, or taking a reduction to 3.75u. Where did the 3.5u dose come from?
I explained to you yesterday that if you wanted to get back on schedule, you could move the shot time by either 15 minutes per shot or 30 minutes once per day or skip a shot and resume on the desired schedule. When you shoot early, it's like a dose increase...when you shoot late, it's like a dose decrease. You do not want to shoot more than 30 minutes early, an hour is ok under certain circumstances, but shooting 4 hours early is dangerous!
Shawn, I'm confused. You shot 3.0u last night, because you were worried about Tubby going low and you falling asleep...I understand that. Then you shot 3.5u 4 hours early today? I'm not understanding your thought process....
I thought you were planning on either staying with 4 units, or taking a reduction to 3.75u. Where did the 3.5u dose come from?
I explained to you yesterday that if you wanted to get back on schedule, you could move the shot time by either 15 minutes per shot or 30 minutes once per day or skip a shot and resume on the desired schedule. When you shoot early, it's like a dose increase...when you shoot late, it's like a dose decrease. You do not want to shoot more than 30 minutes early, an hour is ok under certain circumstances, but shooting 4 hours early is dangerous!
Laurie and Mr Tinkles
Member Since 2010
Re: 12/08 Tubby AMPS 307 +1.5 241 + 3 175 +4 151 +5.5 134 +
How did you decide how much to lower the dose to adjust?
Shawny2u said:
How did you decide how much to lower the dose to adjust?
Re: 12/08 Tubby AMPS 307 +1.5 241 + 3 175 +4 151 +5.5 134 +
Shawn....I think what we are all trying to say is that lantus takes consistency. You should do your absolute best to always shoot the same time in the morning and then 12 hours later...the same time in the evening. IF you have to stall on a shot, then, as Laurie said, you can make the time up in one 30 min increment a day until you are back on schedule or at 15 mins each shot time. For example, two days ago, we had to stall Gracie for two hours...her normal shot times are 7:30 a.m. and 7:30 p.m. I shot at 9:30 p.m. while waiting for a rising number from a +12 of 51 that was dropping. So yesterday, I made up 1/2 hour and shot at 9 am and 9pm. Today, I made up another 1/2 hour and shot at 8:30 am and 8:30 pm; tomorrow it will be 8 am and 8pm; and finally on Friday, we will be back on schedule at 7:30 am and 7:30 pm. I chose to do it that way to keep the shots on the 1/2 hour instead of also having to deal with quarter hours. When I did stall on Monday, I shot the full dose of 1u that I had been shooting for several cycles and that I'm still shooting because we are data ready. So I didn't vary her dose. When we say that shooting early means a dose increase, it doesn't mean that you should just decide to increase the dose so you can shoot 4 hours early. What it means is that by me, again, for example, shooting Gracie at 9 am on Tuesday morning, I had an implied dose increase because I actually shot her at +11.5 instead of +12 so I was giving her the same dose (1u) but giving it 1/2 hour early. The amount of that increase is so minute at her dose that there really has been no discernible change in her numbers. Stalling or shooting a reduced dose isn't the best scenario but sometimes we have to do it and it really helps to get FDMB input. If you decided to shoot 3.75u as your new consistent dose, you should have waited to see what he was doing at +11; if at +11, he was (for example using todays numbers) 60, then he is falling. When you would check at +12, if he was 52, then you would want to NOT FEED, stall, and not shoot a dropping number...you would want to post immediately and you would get the advice as to whether you should continue to NOT FEED and stall for a rising number, OR whether you should shoot a reduced dose for that cycle, or whether you should skip the shot...depending on how data ready you are. And I'm not sure you are data ready yet to shoot a low, albeit rising, number.
We all know Tubby has other health issues and so I would think consistency is even more important than ever. We are only trying to help you obtain that for him. I hope I was able to articulate that and please ask us any questions at all if I muddied it...and I will offer my apologies.
Shawn....I think what we are all trying to say is that lantus takes consistency. You should do your absolute best to always shoot the same time in the morning and then 12 hours later...the same time in the evening. IF you have to stall on a shot, then, as Laurie said, you can make the time up in one 30 min increment a day until you are back on schedule or at 15 mins each shot time. For example, two days ago, we had to stall Gracie for two hours...her normal shot times are 7:30 a.m. and 7:30 p.m. I shot at 9:30 p.m. while waiting for a rising number from a +12 of 51 that was dropping. So yesterday, I made up 1/2 hour and shot at 9 am and 9pm. Today, I made up another 1/2 hour and shot at 8:30 am and 8:30 pm; tomorrow it will be 8 am and 8pm; and finally on Friday, we will be back on schedule at 7:30 am and 7:30 pm. I chose to do it that way to keep the shots on the 1/2 hour instead of also having to deal with quarter hours. When I did stall on Monday, I shot the full dose of 1u that I had been shooting for several cycles and that I'm still shooting because we are data ready. So I didn't vary her dose. When we say that shooting early means a dose increase, it doesn't mean that you should just decide to increase the dose so you can shoot 4 hours early. What it means is that by me, again, for example, shooting Gracie at 9 am on Tuesday morning, I had an implied dose increase because I actually shot her at +11.5 instead of +12 so I was giving her the same dose (1u) but giving it 1/2 hour early. The amount of that increase is so minute at her dose that there really has been no discernible change in her numbers. Stalling or shooting a reduced dose isn't the best scenario but sometimes we have to do it and it really helps to get FDMB input. If you decided to shoot 3.75u as your new consistent dose, you should have waited to see what he was doing at +11; if at +11, he was (for example using todays numbers) 60, then he is falling. When you would check at +12, if he was 52, then you would want to NOT FEED, stall, and not shoot a dropping number...you would want to post immediately and you would get the advice as to whether you should continue to NOT FEED and stall for a rising number, OR whether you should shoot a reduced dose for that cycle, or whether you should skip the shot...depending on how data ready you are. And I'm not sure you are data ready yet to shoot a low, albeit rising, number.
We all know Tubby has other health issues and so I would think consistency is even more important than ever. We are only trying to help you obtain that for him. I hope I was able to articulate that and please ask us any questions at all if I muddied it...and I will offer my apologies.
Re: 12/08 Tubby AMPS 307 +1.5 241 + 3 175 +4 151 +5.5 134 +
Shooting early is like a dose increase. Shooting 4 hours early is a massive dose increase. I doubt that I would have been comfortable shooting 1.0u if I shot that early and, frankly, I would never shoot that early. If I was that far off schedule and needed to get back on schedule, I would skip a shot and the following shot would be at the desired time.
What you are not taking into account is that with long acting insulin like Lantus, there is overlap between shots. This is both normal and desirable. If you shot 4 hours early, you can easily end up with the nadirs from both shots being too close together. There is a huge risk of numbers plummeting and your not being able to easily control the drop.
You will need to monitor very carefully both this cycle and your evening cycle tonight. In many cases, you may see some impact on the current cycle but you can also see the effect of this kind of dosing on the next cycle or two, as well.
Please, for the safety of your cat, ask about an early shot before you pick up the syringe. There are very knowledgeable people here and we will do our best to help you and inform you. Many of us has stayed up into the early hours of the morning with a cat that has been overdosed. It's not fun for anyone.
Shooting early is like a dose increase. Shooting 4 hours early is a massive dose increase. I doubt that I would have been comfortable shooting 1.0u if I shot that early and, frankly, I would never shoot that early. If I was that far off schedule and needed to get back on schedule, I would skip a shot and the following shot would be at the desired time.
What you are not taking into account is that with long acting insulin like Lantus, there is overlap between shots. This is both normal and desirable. If you shot 4 hours early, you can easily end up with the nadirs from both shots being too close together. There is a huge risk of numbers plummeting and your not being able to easily control the drop.
You will need to monitor very carefully both this cycle and your evening cycle tonight. In many cases, you may see some impact on the current cycle but you can also see the effect of this kind of dosing on the next cycle or two, as well.
Please, for the safety of your cat, ask about an early shot before you pick up the syringe. There are very knowledgeable people here and we will do our best to help you and inform you. Many of us has stayed up into the early hours of the morning with a cat that has been overdosed. It's not fun for anyone.
Re: 12/08 Tubby AMPS 307 +1.5 241 + 3 175 +4 151 +5.5 134 +
You are articulate and right down to the point, I do agree with everything you said and will raise questions and ask for help when is needed. Its nice having mature people with knowledge around who sincerely care. Thank you!
Marjorie and Gracie said:
You are articulate and right down to the point, I do agree with everything you said and will raise questions and ask for help when is needed. Its nice having mature people with knowledge around who sincerely care. Thank you!
Re: 12/08 Tubby AMPS 307 +1.5 241 + 3 175 +4 151 +5.5 134 +
As the last poster said and I agreed, I do think its critical to monitor closely. I am aware of risks of early shot on long lasting insulins and just like I mention to the previous poster you are right. Frankly at this point of the game i'm more concerned about his next shot. And concentrating on the strategy as how to proceed. However your observation is quite logical and I do appreciate your inputs, thank you!
Sienne and Gabby said:
As the last poster said and I agreed, I do think its critical to monitor closely. I am aware of risks of early shot on long lasting insulins and just like I mention to the previous poster you are right. Frankly at this point of the game i'm more concerned about his next shot. And concentrating on the strategy as how to proceed. However your observation is quite logical and I do appreciate your inputs, thank you!
Barbara and tuffy
Member Since 2009
Re: 12/08 Tubby AMPS 307 +1.5 241 + 3 175 +4 151 +5.5 134 +
How is Tubby doing? Hope all is going okay. We all learn lessons by doing. Good luck.
How is Tubby doing? Hope all is going okay. We all learn lessons by doing. Good luck.
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