12/2 Oreo Low Numbers: afraid to give shot???

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oreosmom

oreosmom

Member Since 2012
Hello Landus Folks,

I am Oreo's Mom, Carol. He has been getting 2 units Landus twice daily. Last night Oreo's PMPS was 142. (Alpha Trak 2 ) We did NOT give shot since it was pretty low and we were going out to dinner. At 8 PM, we tested again, and it was at 136.
So we didn't give the shot and decided to wait until this morning. This AMPS was 136. For Oreo this is very low. (he is on prednesilone fo GI Lymphoma)) I fed him and it is now at 191. I don't know whether to reduce his dose and still give him 2 units?. I'd appreciate your opinions. Thanks!
 
Hello there

I dont remember seeing you recently on this forum. do you have a profile with more info on your kitty? What are you feeding him?

I am looking back at the SS and in the past you have given 2IU at 116 and 127 (16th and 14th of November) but was that the other meter though? It can be scary to shoot at numbers that are lower than you are used to, so it may help to read our stickie on shooting at low numbers.

We dont usually reduce the dose unless they drop under 40 (long term diabetic ie a year) or 50 (recent diabetic).It may help to read our stickie on the protocol too.
 
Hi, Carol and welcome to Lantus Land.

One suggestion right off the top would be to use one meter. It looks like you alternate between an AlphaTrack and a Relion meter. It looks like you know that the AT reads 30 points higher than a human meter, which is good! Sticking with one meter will make it easier for you (and us) to be sure whether Oreo needs a dose change and reduces the chance of an error. I'd also encourage you to get at least one test in addition to your pre-shot tests, each cycle. Lantus dosing is based on the lowest point in the cycle (nadir) which is usually somewhere toward the middle of the cycle. Pre-shot numbers are helpful with respect to whether it's safe to give a shot; dose reductions are based on the lowest number in the cycle.

If you're opting to follow the Tight Regulation Protocol, you wouldn't reduce Oreo's dose unless numbers drop below 50 on a human meter or 80 on the AT. You may want to take a look at this post on how to handle low pre-shot numbers. Skipping the shot is one of several options -- although I agree that skipping last night may have been a good idea.

I'm not sure if you're asking if you should shoot late. If your schedule can accommodate a late shot, it's fine. However, you need to consider that your PM shot will be 12 hours from when you shoot this morning. For most people, if you are more than 2 hours off schedule, it's hard to adjust the time and they'll skip. What I would point out is that it looks like you were comfortable shooting a 199 yesterday morning. The 176 today is pretty much the same number. (There's 20% variance in any test due to meter variance.) That said, it takes a bit of time to get comfortable with shooting lower numbers. We also don't tell you to shoot and then abandon you. Rather, there are lots of people here with experience in managing lower numbers (and there are written guidelines) who will stick with you and help you should Oreo's numbers drop and you're not sure what to do.

I also would point out that not every cat experiences big changes in BG numbers due to taking a steroid. Whether or not the prednisolone effects Oreo's numbers really isn't an issue. For anyone who's cat is dealing with medical issues, we work the insulin dose around the other health issues and other medications.

I'd encourage you to look over the starred sticky notes at the top of the board. They will give you a solid foundation in using Lantus to manage Oreo's FD. Please let us know how we can help!
 
Hi Sienne and Gabby,
Thanks, that's very helpful! We feel better that we did the right thing. This morning Oreo was 176 when we tested him before breakfast; an hour later it was 191 - the same, given the 20% range. We get most nervous when we can't be around to watch him, in case he goes hypo. We need to take Grandma back to her home in LA today, so we gave Oreo a reduced shot this AM (1.0 vice his usual 2.0). We'll check him before we leave and again when we get home later today.

BTW, we've been using the Alphatrak-2 we got from the vet when Oreo was diagnosed. Most people on the site seem to use people meters to save $$$, so we've been experimenting with the One-Touch and the Relion, while using the AT2 as the gold standard, for comparison. However, that seems to be introducing another factor of uncertainty. Oreo was diagnosed about 6 months ago, and we obviously don't have it down yet. We pretty much decided to just stick with the AT2 until we really have the whole process down. (...and eat pasta for the nest 10 years!)

A couple more questions: (1) How did you decide what meter to use? and (2) Do you need to subscribe to the Lantus forum?

Thanks again!!
 
No you don't need to subscribe to the forum. Doing so, you'd get a notification that a new post has been made every time someone posts here. That could be over 100 per day:-)
If you subscribe to an individual topic, you'd get notified if somebody responds to it. That can be useful if you're following a specific thread (called a "condo" here). Especially if it's a topic you started, and you are waiting for a response to a question.

Using the AT is fine. You should note in your signature or in the subject line of your daily condo, that the AT is your meter so everyone who advises knows that.

I used a Relion Micro with Bob, and the primary reason was cost. My vet recommended it to me.

Carl
 
I started here some time ago. When I was still completely overwhelmed by managing Gabby's FD, I started doing research on meters (and everything else, for that matter). I came across a site for juvenile diabetes that gave good ratings to the Bayer Contour meter along with a few others, based on reliability and the need for a small amount of blood. Between that recommendation and the pharmacist at the Walgreen's near me who gave me a coupon for the meter, that's how I decided to use the Contour. I'm currently toying with the idea of switching to an Arkray meter. (This is the parent company that manufactures the Relion meter.) I may get one and do some comparisons. The cost for strips with the Arkray is far less than for a Contour. I'd encourage you to use a human meter. The cost savings is huge compared to an AT. In addition, if you run out of strips for an AT, you can't easily go to a store and pick up some extras to tide you over.

Like Carl said, you don't need to subscribe. You will be bombarded if you do -- this is a very active forum and people here are very social. If you post in other people's threads/condos, they will stop by and visit. (In addition, reading other people's posts and looking at their spreadsheets is a great way to learn.) While the focus is on the cats, people here are very supportive and recognize that caregivers are emotionally invested in the well being of their cat and that we all have stresses in our lives that we sometimes want to share with the group. This is truly an amazing place where you really do feel like you know the people despite never having met face-to-face.
 
This is truly an amazing place where you really do feel like you know the people despite never having met face-to-face.
Click to expand...
Completely agree. I've never met fact-to-face with anyone from FDMB, and only have talked to a couple of them on the phone. But I consider many people on the board, and on this forum, as true friends. We're all bonded by this experience, and once someone posts here, we feel we know them, and that we have sort of a shared "ownership" with them and their kitties. Amazing place, filled with "crazy internet cat people" :lol:

Carl
 
Hello. I just wanted to drop in and say welcome to LL. I agree with Sienne and Carl, this is a wonderful place with wonderful people. Our cat, PurrFace, was diagnosed about the same time as Oreo. We were overwhelmed and scared of doing the wrong thing but the folks on this forum cured that. It's so comforting to know that if you have a problem you can post here and someone is going to help you.

Have a great evening and I hope you are a regular poster.
 
Hello Bob, Sienne and Frosty,

I can't tell you how thankful I am for your replies. At first, in April, I thought I would never get this down. I was in tears. I couldn't imagine second guessing my vet's opinion....they are supposed to be the "real experts". I kind of thought your group was just a bunch of nice- but nutty -people testing 4-7 times a day. But after watching her tech poke the bottom of Oreo's paw for blood (OUCH!), and being told things like " give the same amount of insulin no matter what....you always can give Karo syrup"! , I now totally understand and embrace this group's philosophy on testing! Had I listened to the vet, Oreo would have been hypo a couple of times. We are now testing 3-4 times a day or more as needed. It is the only responsible way in our opinion. Yesterday I actually told the vet that we would be doing frequent testing no matter what her opinion is. ( we will see how that goes! ) Anyway, I am so very, very grateful to you for all of your help. I still feel like a complete idiot with nadirs ( FYI: the vet's tech didn't know what that was) , curves, etc. and pre-warn you all that I will be asking lots of questions!

God Bless,

Carol...Oreo's Mom
 
Welcome!
Ask all the questions you want!
There is always something to learn around here. It all takes time to soak in.
My vet is pretty good about a lot of the diabetic but she missed things too. I helped her learn some things about dealing with diabetes.
She still is amazed at how I jumped in with both feet and took over. She said they have never had any bean do so much for their pet.
And I learned it all right here.
 
Hi Carol. I don't give advice...I'm still taking. :-D I wanted to welcome you and Oreo :smile:

I had to laugh out loud at the comment that you thought we are all nutty. I stayed away from this group for a long time, because I was told "they are snobs"......that couldn't be further from the truth.

People here are very friendly, and willing to share information with each other.
We care about one another personally as well as our cats.
Welcome :-D
 
Welcome to LantusLand! Yep, we're Crazy Cat People! But I really don't see how others manage FD without the support here, everyone I know think I'm totally obsessed.

How about starting a new thread (condo, as we call it.) We start a new one every day, updating test results throughout the day in the subject line on the first post. That way others can keep an eye out for you and we get to know the cat better.
 
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