2018-03-22 Emmett-dose-advice-please - AMPS (5.8/104)

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Just checked BG and he’s at 5.8/104

Do I skip? I know it’s not quite green.

This is only his second dose at 3.0 units.

@Wendy&Neko
@Stacy & Asia
@Bobbie And Bubba

 

Are you able to be home to monitor today? If yes, do you have plenty of supplies and HC food and karo or honey?

 

I will be here for another hour. I checked again. I think I’ll shoot. He’s done this before.

 

It looks like he is clearing a bounce, so hopefully he won't keep going down. You may need to leave some food out for him. Good luck.

 

Rob, if you did shoot all ready, please make sure you get another test in at +1 as this is the lowest number you have shot before. He could start to go back up again in bounce mode, but then he might decide to go down. If he is lower at the +1 than his pre shot number, you would want to give him some food to slow him down. Depending on how much lower will decide whether it is just low carb food or some higher carb food.

 

@Bobbie And Bubba ya I will be testing again in about 10-15 mins. He seems fine now behavior wise.

If it’s low or even if it’s not I’ll leave out some more food.

If it’s low still I may have to think about working from home


Rob

 

I wish it was Friday it’s my curve day then there would be no worry

 

@Bobbie And Bubba

+1 8.3 (149)

I will leave some food out.

 

Good plan to leave some food out.

 

This is going to be a very long day for me, but everything I’ve read indicates it’s safe with Lantus (obviously as long as he has a regular curve day). That said, if I’m presented with yet another lowish number tonight do I still “hold the dose” of 3.0 IU.

I read in one of the articles in the FAQ section you hold the dose and once consistently in the range of 50-100 (for a week), or 3 times -- 3 seperate days 40-50, start reducing by 0.25 iu per cycle.

Is this the correct procedure? Please correct me if it's not.

@Bobbie And Bubba
@julie & punkin (ga)

 

Hey Rob, since you just increased 3 cycles ago to 3 units, you are going to hold this dose for a total of 6 cycles and then evaluate whether he will need another increase or not. If he goes below 50 before 6 cycle, then of course you would give him a reduction. If he starts giving you some greens, you will be holding the dose.

Since tomorrow is your curve day you should get some good useful information and the depot from the 3 units should be full. That will help you know how this dose is working for him.

 

@Bobbie And Bubba

Hey Bobbie,

So I’ve read ALOT but this depot, I understand that Lantus builds up in the cats system as crystals and I guess this happens due to saturation or something.

This depot, it’s not important but is it like a pocket of insulin crystals or does the body store it somewhere? I only ask because say I’m switching injection sites from left side to right side for instance. Does it all wind up building up the same depot or should I be keeping within the same general vacinity on Emmett.

I’m not sure it’s a stupid question but I’ve been wondering this since the start.

Also, for reduction, I assume 0.25 IU? What is considered a low dose and what’s considered a Hugh dose?


Rob

 

There are no stupid questions here. I am learning something every day here.

With the depot, each time you give a dose, only some of it is being used and the rest goes into storage for use later. It is a good idea to be changing up your injection site as you are doing so that scar tissue doesn't form which would effect absorption. Switching the injection site has no bearing on the depot storage.

The below is about the depot and how it works.

Depot

As far as reductions, yes, they are done in increments of .25 IU just like the increases. As far as what is considered a low dose: that would be the tiniest amount which is a drop. A high dose? That's relative as we have some high dose kitties here getting as much as 16 u twice a day. We don't start to think about high dose conditions such as acro or IAA until a kitty has gone over 5 units. Bubba hit 5.25 units and then started racing down the dosing ladder.

 

We have a kitty here getting over 50 units BID. Each cat has different requirements for insulin. ECID. We suggest testing for high dose conditions when a kitty gets to 6 units, but cats can have high dose conditions on lower doses. It's just that if they get to 6, the chances are really good a high dose condition exists. At this point, it's too early in Emmett's dance to be thinking high dose condition. As far as dosing is concerned, we stick with 0.25 unit increases, until kitty gets to 5.0 units at which point we'll typically go to 0.5 unit increases.

 

Thanks Wendy. See Rob, I am still learning! I got confused with the larger increases after 5 units and testing for high dose.

 

Thanks both of you! Great info. I had read that depot post before, but I guess it didn’t really “click” until I actually started experiencing it.

So from my understanding, when Emmett is on a lower dose than 3.0 iu, I’m guessing he’s using up all the previous depot stores from dose to dose, but when at 3.0 iu I think it’s actually accumulating and he has a depot “store” to draw from when his numbers start rising. I know it not that simple but that’s how I’m understanding it.

50 units! Wow. I guess that’s half my syringe! How big is the Lantus vial? Is it 100 units?


Rob