2/26 AM update Boris SS updated

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Patti and Merlin

Patti and Merlin

Member Since 2009
viewtopic.php?f=9&t=25897

Good Morning everyone. I'm up and off to work here again in a few minutes.

THANK YOU Helene and Tena for your support on the "surfing". I really am trying to learn the lingo and ideas behind this Lantus. I didn't know if I was supposed to do something different when you mentioned letting Boris just surf! DUH!!! :lol:

I've updated his SS thru +8 this AM. I hope I have another calm day at work like yesterday - (we NEVER say the Q word) - it was the easiest one I've had in..... well forever it seems. That was why I could keep everything updated between calling DH and writing here.

But if you could look at Boris' numbers. I read how important the +1 and +2 and +10 and +11 are. Also today is another "Pred" day. We had one GOOD day on Pred but 2 not so good days on it. I'll be curious what today brings. The other day on Pred with yellow numbers - was a day after I waited 2 hours to dose him and wondered if that had played into the picture.

Again - I thank all of you for your help and support and putting up with this slow but sure learner! :smile:
 
Re: 2/26 AM update Boris

Wow! Boris had an absolutely beautiful day yesterday! Nothing better than a day of greens! Technically, he earned a reduction for this morning, but I wonder if the dosers will want you to hold since he's also been getting the yellows?
 
Re: 2/26 AM update Boris

Patti and Merlin said:
http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=25897


THANK YOU Helene and Tena for your support on the "surfing". I really am trying to learn the lingo and ideas behind this Lantus. I didn't know if I was supposed to do something different when you mentioned letting Boris just surf! DUH!!! :lol: :
Click to expand...


Hey, me too. We are all learning here. This forum is such wonderfully supportive place and has an encouraging enviroment for learning. Like a study group.....This group also likes having parties......any chance they can get.

cats-have-a-study-group.jpg
 
Re: 2/26 AM update Boris

We still have 1 more hour before dosing so if anyone thinks we should change......I know joe was going to check a +11 and then of course an AMPS which I'll call and get posted! I'll ask him to hold off a little before he doses in case someone has a chance to tell me if I should change anything! confused_cat

Thanks heather for stopping by - it's always so good to see you! dancing_cat
 
Re: 2/26 AM update Boris

At the moment, I can't see anything that would prevent you or Joe from shooting save a way low number. Great day for Boris yesterday!!
 
Re: 2/26 AM update Boris

verra nice. :smile:

Heather is right, technically Boris did earn a reduction yesterday. Refresh my memory, though, was Boris previously OTJ and just started back on insulin? I think that's what I'm remembering. Sometimes we hold doses longer for cats who have returned from the Falls because usually it's harder to get them back there a second time.
 
Re: 2/26 AM update Boris

Hi Libby,
We got Boris in January using Vetsulin 2 units bid but no hometesting. Once we got him - we started testing right away and within 2 weeks got him off insulin. But over the last few months he's gone on/off insulin for several days here/there. No real reason ever - one time he had to get shaved (he came to us with horrible mats) and he went on insulin for 4 days then - other times - no reason at all. This time tho - a month ago he became sick with elevated Liver function tests - not eating well at all. He's on Prednisolone, ursodial, denmarin (but off subq fluids for weeks now and needed only 1 dose of mirtazapine). He eats like a champ! Ever since the pred was started tho - he's needed the insulin. I kept him on the vetsulin at first just to see if it was temporary again but it became obvious within days this was a long term thing.

I'm still at work and it's been busier today so haven't been able to call home as much. I'll try to update the SS shortly. But if you think we should change anything could you please let me know. I'll be able to check back later tonite when I get home from work - about 6 hours from now. My only concern is I'm scheduled to work tomorrow - the first time Joe and I will both be gone with Boris running on lower numbers. It looks like I mite be cut tomorrow but as usual I'm thinking ahead.

THANKS soooo much!
 
Re: 2/26 AM update Boris

Patti,
I don't have much to say except that if you are ever worried about going low and nobody will be around, then go with conservative, and leave out lots of food. I think most kitties eat instinctively when they go low.
So if you're not sure what to shoot, then shoot the lower amount because it's alot easier to come home to a high number than a low one!
Good luck but I am sure you will do the safest thing for Boris.
 
Thanks Gayle - was kind of thinking along the same idea you just gave me! :smile:

It looks like boris is going to stay green thru this cycle again if all goes well. This will be the 4th cycle if I counted right of almost all green. Does this qualify for a decrease? I'm sorry I haven't been able to read much more these last 2 days. I'm comfortable with the numbers he has - just wondering....

it would be easier on my eyes to measure 0.5 vs 0.75........... :lol: dancing_cat
 
Here you go; is this what you wanted:

"General" Guidelines:

--- Hold the initial starting dose for 5 - 7 days (10 - 14 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 cycles).

--- Each subsequent dose is held for a minimum of 3 days (6 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 cycles) if nadirs are less than 200 before increasing the dose.

--- After 3 consecutive days (6 cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.

--- After 3 consecutive days (6 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.
 
Thanks Gayle. I had read that. And I consider Boris a "long term diabetic" as he was a known diabetic for 2 years I was told when we adopted him. Just new to Lantus.
So seeing he went to 46 during the nite and has stayed in the greens all day and people were mentioning that "technically" he earned a reduction today - except for that day of yellows the other day. but the more I think about it the more I think that yellow was all due to me holding his shot for 2 hours as I wasn't sure how low I could shoot at the time with the Lantus. THAT's what I'm having to learn.

So tonite - I think we'll decrease to 0.5units. It looks like I won't be working tomorrow unless there's an awful lot of really sick patients come in tonite. And then I'm off the rest of the week to do alot of testing. How do you think that sounds? Am I rushing things too much?

THANK YOu so very much. I so appreciate all the help!
 
Okay, Patti - now you've done it - Dude (and I) are very jealous of Boris' numbers lately -

Way ta' go, girl. You rock. Keep up the good work.

Hugs,

Emmy & Jealous Dude (& Modern Mittsi too, of course)
 
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