5/1 dose reduction after a drop? Lantus 5U

EarthyCarbonCookie

EarthyCarbonCookie

Member Since 2020
Question for admin, non-emergent.


Carl has been doing well the last few months. I've creeped up his Lantus to 5, he was doing well to stay in the 200's. Yesterday I came home and he had not eaten and his numbers were low and continued to drop at shot time. Just to 77 but low enough to not shoot. So I gave a medium carb snack and checked later and it hadn't really moved so I gave him a higher carb food and got to 116. This morning was 346 preshot. Obviously I need a dose reduction but how much do I reduce by? What would cause him to just stop eating? He eats Fancy feast beef or chicken and a mix of Dr Elseys Clean Protein chicken mixed 1:1 with Epigen 90. I got a donation awhile back and Dr Elseys was hard to find but he liked it so I mix it. He's a total crunch addict.

He's acting normal and when offered free dried or cooked treats he eats them. I think he's really out to get me.

I don't have an recent full curves, only spot checks. Between working way more hours than my health allows and a few emergencies with other pets, I've slacked on the curve.

((Carl has to live in a large enclosure in the house (PVC pipe and trampoline net for now) because she started out feral and will leave through any means necessary and revert back to a wild man. He wears a bell now so I can tell if he's chewed his way out again. I love him so much.))

He did get half can of American Journey chicken? Don't have the can any more. A friend stopped to feed and dose and grabbed from the wrong pile. It doesn't seem like a horrible food and it didn't seem to affect his numbers in the days following

https://docs.google.com/spreadsheets/d/1o2TtT2zwAgZtGINxtkb8nu_Ye_6Y0eKhZyJpO8ew7mA/edit
 
Hi!! For some reason Cant tag anyone :eek: but hopefully someone gonna help soon. Im gonna watch ur thread :bighug:
 
I'm past the window for shooting, it's too far past when I normally would give a dose. I'll wait for advice.

The next two days are going to be heinous as I won't be home to properly test, I have no one to test, only feed and shoot, rural and friendless. I'll be driving and gone 12-13 hours the next three days.
 
Sent it! Hopefully u will get answers to some of ur questions!! :bighug: And I know the feeling I barely can use any help if it comes to my cat. Like my partner will do the insulin. But can’t do the ear poke etc :confused:
 
Paulina said:
Sent it! Hopefully u will get answers to some of ur questions!! :bighug: And I know the feeling I barely can use any help if it comes to my cat. Like my partner will do the insulin. But can’t do the ear poke etc :confused:
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It doesn't help that Carl is a former semi-feral and over the last few years has adapted to me
 
Hi. Since lantus is dosed based upon the nadir you need to see what it is by either a weekly curve or getting a test between +4-8 when possible. Cats go into danger of a hypo when they fall under 40 with a human meter so 70’s aren’t danger time. He didn’t need hc but I see why you fed some. He’s likely been this low before but since you only have gotten preshots most of the time we don’t know. Please reduce his dose to 4.5 tomorrow morning.
 
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tiffmaxee said:
Hi. Since lantus is dosed based upon the nadir you need to see what it is by either a weekly curve or getting a test between +4-8 when possible. Cats go into danger of a hypo when they fall under 40 with a human meter so 70’s aren’t danger time. He didn’t need hc but I see why you fed some. He’s likely been this low before but since you only have gotten preshots most of the time we don’t know. Please reduce his dose to 4.5 tomorrow morning.
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I was hoping someone gonna advice to reduce the dose as I thought it’s safer option as per few busy days ahead.
 
EarthyCarbonCookie said:
I'm past the window for shooting, it's too far past when I normally would give a dose. I'll wait for advice.

The next two days are going to be heinous as I won't be home to properly test, I have no one to test, only feed and shoot, rural and friendless. I'll be driving and gone 12-13 hours the next three days.
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What time is his shot? And what time u have to leave the house??
 
Paulina said:
What time is his shot? And what time u have to leave the house??
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I'm home tonight and I will either leave at 8am tomorrow morning or 6am, depends on who else is on call. If 6am Monday USA Eastern Time, my son can shoot but not test.

Normally at 8pm EST I would test and shoot.
 
If you're following SLGS, then you would reduce the dose to 4.75u since Carl's numbers dropped below 90.

The minimum number of tests you need to be getting is 4 -- your two pre-shot numbers (AMPS, PMPS) and at least one additional test each cycle. Lantus dosing is based on the lowest number in the cycle and not on the pre-shot number. It looks like yesterday was one of the few times you had any tests beyond your pre-shots. I suspect that you may have missed some dose reductions! Is it possible for you to start getting more tests on a regular basis?
 
Sienne and Gabby (GA) said:
If you're following SLGS, then you would reduce the dose to 4.75u since Carl's numbers dropped below 90.

The minimum number of tests you need to be getting is 4 -- your two pre-shot numbers (AMPS, PMPS) and at least one additional test each cycle. Lantus dosing is based on the lowest number in the cycle and not on the pre-shot number. It looks like yesterday was one of the few times you had any tests beyond your pre-shots. I suspect that you may have missed some dose reductions! Is it possible for you to start getting more tests on a regular basis?
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Tiffmaxe adviced 4.50 and I’m not sure if it was already done for the evening shot?
 
Sienne and Gabby (GA) said:
If you're following SLGS, then you would reduce the dose to 4.75u since Carl's numbers dropped below 90.

The minimum number of tests you need to be getting is 4 -- your two pre-shot numbers (AMPS, PMPS) and at least one additional test each cycle. Lantus dosing is based on the lowest number in the cycle and not on the pre-shot number. It looks like yesterday was one of the few times you had any tests beyond your pre-shots. I suspect that you may have missed some dose reductions! Is it possible for you to start getting more tests on a regular basis?
Click to expand...


I would like to be able to get more tests in. I would like to fill in my spreadsheet like everyone else that has a test every two hours 24 hours a day. I'm so envious of those! But as it is, it’s just me, I don’t have any neighbors, I live way out in the country and live alone. I work way more than my health allows and spend two hours twice a day doing animal care, sometimes after a 13 hour day. My son will help when he is able, and does more if I have heath issues and can't do it. Staying up to fret over him and test the 3 times I did has offset my sleep and I'm barely functional today. It's a disfunctional life.

I may see if I can get a freestyle on him, do you think that would help gather numbers?

Thanks for the advice, always
 
tiffmaxee said:
Hi. Since lantus is dosed based upon the nadir you need to see what it is by either a weekly curve or getting a test between +4-8 when possible. Cats go into danger of a hypo when they fall under 40 with a human meter so 70’s aren’t danger time. He didn’t need hc but I see why you fed some. He’s likely been this low before but since you only have gotten preshots most of the time we don’t know. Please reduce his dose to 4.5 tomorrow morning.
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Hi Elise, Sienne suggested to reduce to 4.75 post #14 what should she reduce to 4.5 or 4.75 and when tonight or tomorrow morning? I see she did not shoot this morning
Thanks Elise
@tiffmaxee
 
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EarthyCarbonCookie said:
I would like to be able to get more tests in. I would like to fill in my spreadsheet like everyone else that has a test every two hours 24 hours a day. I'm so envious of those! But as it is, it’s just me, I don’t have any neighbors, I live way out in the country and live alone. I work way more than my health allows and spend two hours twice a day doing animal care, sometimes after a 13 hour day. My son will help when he is able, and does more if I have heath issues and can't do it. Staying up to fret over him and test the 3 times I did has offset my sleep and I'm barely functional today. It's a disfunctional life.

I may see if I can get a freestyle on him, do you think that would help gather numbers?

Thanks for the advice, always
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@tiffmaxee

I'm not familiar with the libre , doesn't someone have to be home to scan it?
 
Diane Tyler's Mom said:
@tiffmaxee

I'm not familiar with the libre , doesn't someone have to be home to scan it?
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Diane Tyler's Mom said:
Hi Elise, Sienne suggested to reduce to 4.75 post #14 what should she reduce to 4.5 or 4.75 and when tonight or tomorrow morning? I see she did not shoot this morning
Thanks Elise
@tiffmaxee
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Yes. It will record but needs to be scanned to see the readings.
I was being conservative because we don’t know how many times there was a drop that low. We didn’t see nadirs. If she’s scanned and this was a first I think 4.75 is fine.
 
tiffmaxee said:
Yes. It will record but needs to be scanned to see the readings.
I was being conservative because we don’t know how many times there was a drop that low. We didn’t see nadirs. If she’s scanned and this was a first I think 4.75 is fine.
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Thanks Elise ,I see in her remarks section she's going to shoot 4.5 , better to be safe since she doesn't have many tests
 
tiffmaxee said:
Yes. It will record but needs to be scanned to see the readings.
I was being conservative because we don’t know how many times there was a drop that low. We didn’t see nadirs. If she’s scanned and this was a first I think 4.75 is fine.
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I can get someone to scan it when I cant, it's the rodeo someone who isn't me goes through to hold him to get a sample. He's cuddly on his terms, but you have to be calm and not rushed.
 
In that case it might be worth a try. They are supposed to last 14 days. Sometimes they fail sooner or cats manage to get them off. I’ve never used one as they were not around when Max became diabetic. There’s the expense of the vet to out it on. I’m not sure how expensive in comparison to the cost of strips. I suspect my vet would have charged a lot.
 
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