2/12 Tink AMPS 84!! Trying for reduction??

[JenM]

Last condo: http://www.felinediabetes.com/FDMB/threads/2-10-tink-amps-132-2-95-still-going.132904/

So, this morning's preshot was a surprise. 84!!!! I went ahead and shot, but I wont lie... it made me nervous. He was a bit lower at +2 so I gave some extra food and stuck around for another test. Down to 65 at +2.5 so I gave him a little bit of hc. That brought him back up to 75 after a few minutes. Needing to go to work, I put a little bit of hc in the feeder along with his lc food. It'll feed him every half hour until +4.5. I hate giving the hc if I dont need to... but I'd rather be safe than sorry, obviously.

But... this morning's preshot brings up a question. I know shooting "normal" numbers is expected with Lantus... but how low is too low?? We shot a 97 a few days ago and he did great, up a little at +2, then down a bit by +4. Surfed into a mid-blue morning preshot. But then this morning's 84, he didn't surf it quite as confidently.

I'm tempted to reduce to a straight 4u (we're at 4.25 now)... but I guess I need to wait till he earns it. He did have one day under 50 back on 1/22 (PM), and got into the 50's again on the 5th of this month. We're on such a roll that I hate to ruin it... but it's hard to go to work after such a low AMPS. Is Mr P waking up???

 

[Marje and Gracie]

Jen

He's definitely looking good on this dose and great job shooting, monitoring, and feeding especially with work.

We typically use 50 (human meter) as the cutoff for shooting lantus meaning, for safety, it's best to not shoot below 50. However, if you are working and you get a dropping number into the 50s and have to leave, I'd certainly really think about that before shooting it. I, personally, might not feel so confident in loading up the auto feeder and leaving but that's something you have to decide for you and Tink.....what is your cutoff number for how you know he responds to food. Also, as his depot gets fuller and he gets closer to needing a reduction, that number might need to change.

If you have the latitude to stall on a work day on a number that is dropping towards 50, that might be a good option and while we don't usually stall and shoot a reduced dose, it would be a consideration depending on where he is and how long before you get back home. Just keep safety first in mind. While the protocol would have you wait until he goes below 50 to reduce, it is a guideline only. If you feel his nadirs are getting a bit too low (even if they are in the 60s) for you to feel comfortable shooting and leaving, then reduce. Let the nadir be your guide.

 

[JenM]

Ok, thanks. That's helpful.

Generally, he responds well to food - especially if I break out the hc. I've been guiding his numbers mostly with low carb (just a bit extra, or earlier than normal) for the most part. If he's still dropping with lc, I break out mc - only this morning I didn't have any, so used hc. Plus he started out so low...

Based on his past performances, as long as he comes right up after eating hc, I feel pretty comfortable setting the feeder to give him more. That's all I've ever had to do at home anyway - feed and test every 30 min. Granted... I know it only takes one time of it NOT working that way for things to go horribly wrong. I've only ever used honey one time, and that was only because he'd already earned a reduction, I was tired of messing with it, and he was getting full. That was quite awhile ago too - and may not have even been on Lantus - I can't remember.

On the bright side... when I leave in the morning, he's not completely unattended. My daughter doesn't generally leave till 9 or 10am (+4-5), so if he were to become symptomatic, she'd call me and I could rush home (and give her instructions as I'm doing so). Unfortunately she's never learned to test (nor does she really want to).

So far 84 is our lowest preshot. If I see anything too much lower, I guess I'll just plan to stall long enough to see if it's still dropping or not. My work is flexible(ish) and since I start earlier than most of my colleagues, I generally don't actually HAVE to be there until around +4. Still... as management I can't just get into the habit of walking in whenever I want - so I tend to rely pretty heavily on my feeder. This morning I walked in, 45min late, expecting to get "a look" when I used the "sorry, kitty had low blood sugar" excuse... then I see a Chihuahua sitting on the counter next to the switchboard. She had a dental appointment so got to come to work till the vet opened. LOL So... my coworkers "get" me.