12/29/12 AMBG 82; Didn't shoot

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Moosmommy

Moosmommy

Member Since 2012
Sorry All, I am still trying to get the hang of all this; pardon if I broke any rules! :)

I tested Moo at 720am before shooting and he was only at 82!
I was just making sure I was making the right decision and not shooting; which BJM confirmed.
I would love!!! LOVE!! LOVE!!!! to be breaking Moo already by controlling his diet! :) After less then a month on insulin!
Here's hoping! :)

BJM said:
Correct, no shot.

Rules of the board Re to post so everyone can review & catch errors.

Start a new post w/ the date , glucose tests , separated by commas, and any question.
AMPS if you give a shot
AMBG if you do not (am blood glucose)

And copy this into it, please.

Doing great! You may be on the way to breaking your diabetic! (Gotten to diet controlled)!
Click to expand...
 
If he is nibbler, that'll keep the glucose more level. If he tends to scarf when you put food down, smearing it across the plate, freezing some of it, or using a timed feeder all help slow down the food intake so it isn't one huge load coming in. This also keeps the pancreas from having to supply a lot of insulin at one time.
 
I put his foo in a but larger bowl an mix it with a bit of warm water too. It takes him about 20 mins to eat it. Sometimes he leaves Some and comes back.

When I get home tonight and test him, what number do you think it would be ok to shoot at? And how much? Yesterday was day 3 of .5. Should I go to .75? Or stay at .5 since i skipped this mornings shot?
Should i start my 3 days of .75 tomorrow ?

Tomorrow I am doing my curve. The vet wanted me to do the curve this weekend. Can I still do the curve if I have to skip the am?
Sorry just wanna figure I out before the time comes and I am scrambling for a quick answer.

Thanks.
 
Unless he is over 200, no shot.

To use Lantus correctly, you want a dose that is safe to shoot am & pm, plus it cannot take him any lower than 50 between shots.

Since you had to skip this morning, I would not increase it.

What you might try, if he is over 200, is a 'skinny' dose where you measure just under the 0.5 line, or aim for 0.25 units (halfway between the 0 and 0.5 markings.

Again, unless he is too low to shoot, you need to give the same dose for at least 6 cycles (3 days) and be checking those nadir values to make sure he doesn't go too low.

Other than that, how is he behaving? Normal pooh? Pee? Playing? Preening/grooming? Purring?
 
Ok. Well see what his number is. He is acting normal. Plays w the other cat and dog. Cleans himself and the other cat using the bathroom and eating.

What does it mean if he's below 200 tonight AND the am? Obviously no shot but, does that mean his food is already causing him to not need the lantus?
 
Yup. And possibly going low the other night.

Get 14 days of that and he's officially Off The Juice. (Anti-jinx)
 
That's okay, it's been 24 hours without insulin so it just indicates that maybe he needs tiny amounts for now.

Carl
 
AMBG 121

Seems hes always lower in the morning, and just at or over 200 in the evening.

Doing the curve today. Hopefully he cooperates. It was TOUGH getting his BG this morning!
 
Do you think it's pointless to do a curve today being as he did not get insulin this mornining?
Or will it be a good thing to see how he does without it and when he needs it and how much he might need?
 
Cats will often go lower at night.

Doing a curve today will still have some insulin effects due to the Lantus depot/shed, so it really isn't free of the Lantus.

If/when you need to shoot again, tonight or tomorrow, only give 0.25 units. This is because you want a dose that is safe to give both am and pm. You'll have to eyeball it and it may help to use 1 syringe as a reference and mark a line where you will measure it.
 
So if I shoot tonight (if over 200?) Only shoot .25?
And then again in the morning... if over 200? or lower?

And do I need to do the .25 for 3 days? Then .50 for 3 days? etc?

Or am I ok just doing .25 tonight/tomorrow then tomorrow night doing .50? and .50 for 3 days again?

So far today the curve looks like this....

AMBG- 121
+2 - 139
+4 - 182

About ready to do the next one in about 15 mins
 
Hi Annie,
What you're trying for is finding a dose that will allow you to shoot the same dose AM and PM. That might be .5, it might be .25.
It's easier to start low, and increase if needed, than to start high and try to find the lower dose that "works".

I think I would try the .25u dose tonight, and unless you see much lower numbers, try to stick with that dose for three days. With three days of consistent dosing, it should be easier to determine which way to go beyond that.

Today's numbers don't look bad at all, but I think they indicate that for now, at least, Moo needs "some" insulin.

You're doing great with this :-)
Carl
 
Thanks Carl.
Ill do the .25 tonight Should I do it though if he's under 200?
It's hard to find .25 those lil syringes are so small! I did get some yesterday with the .5 markings so it'll be easier then with the 1.0 markings at least!
 
Shooting under 200 is okay, provided you are comfortable doing it. If you take a look at the spreadsheets of people who have lots of experience with Lantus, you'll see that it is fairly common, because they have collected the data that gives them the confidence to do so.

Go to the Lantus TR forum, and look at two of the stickied threads. One discusses "low numbers", and another (the "new to the group" one), has pictures of small dose in syringes which should give you an idea of what .25u looks like.

A great idea, if you decide to shoot under 200 is to get another test at +2 or +3 after the shot. Those tests may give you an indication as to what the rest of the cycle might look like. If you see a drop in BG early in the cycle, you can react "early" and slow the drop in numbers.

Of course, if you have concerns or questions, post here or on the Lantus forum and someone will help you out.

Carl
 
At 1.0 units, he got some really low numbers, and then was just under 200; after the previous night's low numbers, too low to give insulin.

At 0.5 units, after 3 days, you had an 82 in the morning, which was way too low to shoot, given you've only 26 days of data recorded.

He is starting to creep up a bit because the shed is wearing off.

I would stick with the 0.25 dose and maybe drop your "no shot" number to 190. That is, if he is at or over 190, go ahead and give 0.25 units and test to see how he does before going to bed.
 
Since he's already in the 200s, it is likely you will shoot tonight (0.25 units).

The real question is if you will be able to shoot tomorrow morning and continue for the minimum 3 days at that dose!
 
FInally done with the curve day!

Happy to say we both survived it without too much stress!

PMBG was just over 200 so I did shoot .25

My updated SS is attached

Hope I did it all right!
 
I can see the spreadsheet perfectly; good job!.

I'll be very interested in how he does overnight and in the morning.
Snag a test before bed if you can and make sure there is some food out if he gets hungry.
 
Great. You know what to do if he is down low again.
(Instructions in Lantus forum for review, though I'm hoping you won't need them)
 
Skip the shot in the morning.


And since I gave .25 tonight.... If I had to skip the shot tomorrow morning, what would I give if ok to shoot tomorrow night? Can't go less then .25 so if too low tomorrow night would I skip the shot again? Though as trend shows he's usually ok to shoot at night at least.
 
Let's see where he is this morning. And remember, we've dropped your 'no shot' number to 190. So long as he doesn't go below 50 at the nadir, and you have data to show it is safe, the 'no shot' number may gradually be lowered when you are testing diligently.


Another tactic for low doses is the drop method. You practice first, by filling a syringe with water, then carefully twist/squeeze out drops of the same size until you can get the same number of drops, all the same size reliably. Then you dose using a number of drops.

It can be helpful to get a magnfier of some sort, such as the Carson Clip and flip if you have glasses, or another type of hands free magnifier if you don't wear glasses (visor/headband, stand mounted, etc) They are available through Amazon, our shopping partner, at the link above.
 
Got in a +6 today :)

I've updated my SS which is attached.
Will feed/test/shoot(if can) at 7pm.

Hope everyone has a GREAT and SAFE New Years!
 
Can't seem to scroll down to see what his +6 was. (Using my phone)

Ah - figured it out - hit View, List to see all lines

155 nadir - nice! Subsequent days may sink a bit lower if continued shooting can be done. Cross your fingers!
 
Good Morning and Happy 2013 !!

I was wondering after the 3rd day at .25.... because the numbers seem pretty...Good?, Do I just stay at .25 or do I try to go to .50 to lower them just a bit?

Just curious!

Another morning AMBG 190 with a .25 shoot.
 
The 3 day hold and adjust process is more useful for cats that are really high and lowering the glucose is more urgent. It would be OK to hold him at 0.25 for a full week to see how that goes, so long as he is safe to shoot and the nadir is > 50.

Your no shot number is 190 for right now; give it the week and that may slide down to 180 so long as his nadirs aren't below 50.

Edited to add: If after 3 full days, If his nadirs are above 150, you may try a 'fatter' dose where you very slightly increase, but not quite to 0.5.

The more test data you have, the more you will know how he responds to the insulin. This keeps him safe ... and lets you sleep at night instead of staying up to test him!

The ideal dose can be shot every 12 hours and has a nadir no lower than 50. That's the goal for right now. If you're one of the lucky ones, you may get to a diet-controlled state.
 
Moo jumped to PMBG 257 tonight
So I gave him a .25 fat dose.
I hope that was right

COuld it be because his midday snack was less than I usually give? I only gave a 1/2 can of Friskies as opposed to a whole.

Just seems a bit high but maybe the shed has run out of build up and the .25 is all he's getting finally?
 
The higher doses have cleared and now the 0.25 dose needs to get stable. It takes 3 - 7 days to stabilize after a dose change - that's why you don't change it day to day. You have to have patience!

HOLD the dose until it has been at least 3 full days with 6 shots AND you have the nadir after the 6 cycles are finished.

Also, when you alter more than 1 thing at a time, if there is a change, you don't know what did it. One change at a time lets you isolate cause and effect.
 
Sorry - just edited what I wrote after seeing your spreadsheet.

You keep wanting to rush this and that doesn't work.

Please print out the Lantus protocol and post it where you can review it frequently.
 
Oh I thought you had said in a previous post that if his Nadir is above 150 I could slightly increase his .25 but not to .50

Maybe you meant after the week at .25?
I wasnt sure.

I do reread the lantus daily.
 
Always hold a minimum of 3 days
- unless too low to shoot, then post & ask

A dose change is based on a nadir taken after the 3 days
- except if nadir ever goes below 50, a dose decrease is earned
- or doses are often skipped because too low to shoot, then dose may be reduced

Objective is safe dose that can be given every 12 hours & takes glucose no lower than 50.

So yes, I meant after the 3-7 day hold, you might need to slightly increase. Sorry if I wasn't clear.
 
Below 190 tonight so no shot!

RIght at the same # as his +6 as well.

I guess that's good? Right?
 
He's doing OK and so are you.

Since he got pretty low on 0.5 units, the next step is to s l o w l y reduce your no shot number, so long as the nadir data stays safely at or above 50. Right now, he's in the middle hundreds at nadir, so it is safe to shoot at a lower pre-shot glucose level.

The Lantus folks call it shoot low to stay low; you want to creep into that carefully.

Let's take the no shoot number down another 10 points to 180.

Give it 3 to 7 days with the new no shot number before adjusting it again, based on a nadirs above 50.

As always, when in doubt, be cautious.
 
So today was the first day of my lower no shot number of 180.... An he was lower than that!
I guess that's good. Hopefully we start to see a pattern or trend.
 
Wow! He's really trying to go off the juice!

See what he is before bedtime; you'll see how much he rises.
 
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