5/12 Lucian needs dose advice

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nckitties3

nckitties3

Member Since 2013
First off, Happy Mother's Day to all. :YMHUG:

As most of you know, I usually hang in 'Relaxed' since I don't feel we qualify for TR. Here's the problem. Relaxed is dead, being a holiday, which is to be expected for a board that doesn't get a lot of traffic to begin with.

The last couple weeks Lucian has been showing progress, but still issues. Recently reduced him to 1.75 from 2.0, because he earned it twice, but it didn't hold, so took him back to 2.0 a few cycles ago and he hit 38 last night. He did the same thing on 2.25 and 2.25S, or 2.0F.

I'm stumped! I held his dose, shot thru the bounce this morning, but am unsure what to do tonight. Should I give him his reduction, but maybe between 1.75 and 2.0, like fat 1.75? I have a hard enough time with the .25's. @-)

Any thoughts are appreciated.
 
Hi, Debbie.

You're welcome to post here any time -- especially if you need extra sets of eyes and RL isn't busy. There are quite a few people who are following SLGS who post here routinely.

Looking at Lucian's SS, one thought I have is that you may have needed to let the 1.75u dose settle a bit longer. With TR, a dose is held for 3 days/6 cycles vs. with SLGS, it's held for a week. If I'm guessing correctly, it looks like you held the dose for 5 cycles and increased when you saw the black PMPS on 5/9. It looks to me like that ugly PMPs was a bounce off of the big drop to 110 earlier that day.

Given that a drop below 40 always means business, I'd suggest dropping Lucian's dose back to 1.75u.
 
Thank you for the input Sienne, I very much appreciate it.

My understanding was not to hold a reduced dose if he continued to climb from it, to go back. I messed up several weeks ago by reducing him too close to together and have been trying to overcome it ever since. Do you think that a dose between 1.75 - 2.0 might be a possibility? Seems that 1.75 wasn't quite enough and 2.0 just a tad too much? I had always held the dose 3-5 day, reduction or increase and was told different for reductions, so that's why I went back.

I seem to be getting more unsure as I go along, rather than getting more confident. I'm considering adding a bolas (?) N I believe, but would have to find someone willing to babysit me, since I know no one with experience in it's usage. Although, lately have seen it recommended to others, whose cat's aren't near has high as often as Lucian. Lucian has only recently had a 9 day period without BLACK, in over 5 months. During which time, he may not have been in the black, he also had very few 'good' numbers. It would seem to me, if I could keep him off those blacks, maybe he would learn NOT to bounce to 600+ almost every dang time he hits green or even close.

I don't feel he is the 'norm' if there is such a thing, and maybe he needs that extra ooomph. Like I said, I'm at my wits end, but know there as got to be something that will help my boy! I've tried everything that has been recommended to me, nothing that seems to offer much improvement for any length of time.

I feel really bad about last night and not testing as much as I should have, but he hit it at the same time I was terribly sick, so I did the best I could. Other times, I was able to stay up and monitor, last night wasn't one of them. Lord knows, I test 10X more than I did 4 months ago. :shock:
 
Just so you know, I have tried for the last 30 mins to be able to get a dose of between 1.75 and 2.0. I can't do it, it's either one or the other. Unfortunately, I have tremors and that prevents me from dosing that precisely, getting anything with a .25 is hard enough and I waste too much insulin as it is. You'll notice on his SS there were a few days that showed a 2.0F or 2.25S, they are the same dose, just didn't know what to call them and couldn't seem to get it accurate. Didn't want you to think I didn't try. :sad:
 
You might want to drop Marje a PM or check in with Anne/Zener. They use digital calipers to measure dose. You might find that easier than "eyeballing" an "in between" dose.

Given how bouncy Lucian can be, I would give a reduction enough time to see if the bounce (no doubt resulting from a number low enough to warrant a reduction) clears and where numbers level out at.

Most people use R (Humulin R or Regular insulin) as a bolus. There are several people here who have experience with R. I would encourage you to ask Libby/Lucy, Dyana/JD, or Marje to take a look at Lucian's SS and give you some feedback. R is VERY powerful and you must micro-dose. The starting dose is 0.1u and you have to do a curve for the first 4 hours. (It's also short acting -- in and out in roughly 4 hours.) If you are concerned about dosing Lantus accurately, you may need to think very carefully about whether R will be a possibility. It's not an insulin where I'd want you to hazard an overdose -- it's too dangerous.
 
I can never remember if it's R or N, I know one is better and one I can get it without a 'script'. I had it written down, but, of course can't find it. I can't use anything that requires a prescription, no way to get it. All I have is the paperwork from the Vet stating he is prescribed Lantus. Unfortunately, I think the N is the one I can get without. Hoping I'm wrong. Can't find my notebook. I USED to be so organized. ohmygod_smile

So, you feel it best I take him back to 1.75 tonight then? Granted, 38 is the lowest he has ever been. I shot thru because of the 600+, when I felt he needed a reduction. I get more and more confused. @-)

I'll drop Marge a pm and see if she may have time to help me tomorrow decide what to do about Lucian. Seems that none of the widely accepted advice works for him. :sad:

Thanks again.
 
nckitties3 said:
Just so you know, I have tried for the last 30 mins to be able to get a dose of between 1.75 and 2.0. I can't do it, it's either one or the other. Unfortunately, I have tremors and that prevents me from dosing that precisely, getting anything with a .25 is hard enough and I waste too much insulin as it is. You'll notice on his SS there were a few days that showed a 2.0F or 2.25S, they are the same dose, just didn't know what to call them and couldn't seem to get it accurate. Didn't want you to think I didn't try. :sad:
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I hate the .25 doses too. I now use calipers that make the dosing a whole lot easier to measure.
I have found that (in my head) it is a lot easier to measure a s2.00 (the plunger just under but still just barely touching the bottom of the 2 unit mark), than a f1.75 which would be somewhere in the middle of the 1.50 unit mark and the 2.00 unit mark. And they are probably pretty darn close to the same thing.

You can get R without a prescription in New Jersey. Please don't try to use it without guidance. It is super powerful.
 
It may be R that I can get, I lost my paper that I had that written on, I called my pharmacy a few days ago to see if I could get Lantus without a 'script', noooooooo. She told me I could get ... without, but can't remember which, maybe it is R. I would never try to use that without someone with a lot of experience holding my hand, no worries there!

I'm sure the difference in 2.0F and 2.25S is probably a drop, but I can't see it and I hate to waste insulin that I don't know how I'll be able to replace.
I know a 1.75F is a HAIR closer to 2.0, but I can't see the hair! ohmygod_smile All the calipers, with even halfway decent ratings, are at least $30, I don't have it. I've checked everywhere, Amazon, Harbor Freight and some other unknowns. The ones under $20 have terrible ratings, I'd want something accurate. I can do inaccurate for free! :lol: :o

I am so frustrated! I want to pull my hair out! :evil:
 
He has come down from AMPS/600+ to PMPS/355, which seems to be what he usually does when he bounces like that. If there has been 1 improvement, it's that he recovers from a low/high bounce the next cycle. Seems like when he does bounce, it's in the same cycle as the low, not 2 or 3 cycles later. But if he bounces from a CS dose or a fur shot, it takes weeks to recover. ohmygod_smile Needless to say, I don't reduce his dose for a lower than normal pre shot bg. I have shot an 84 I think, with no problems. He does do better when his dose is consistent, even with a lower pre shot bg.

I decided to go with the 1.75 tonight and will hold it a minimum of 3 days/6 cycles, probably more, like I have in the past. Even if his numbers aren't great, maybe he needs a couple more cycles to adjust to a reduction. Maybe other cats are different and after a couple cycles it's obvious they need to go back up, maybe it takes him longer. He's never been like any other cat, why would he start now? :o

Anyway, thanks for the help, I appreciate it very much.
 
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