? 5/24 PMPS 87 STALLING 7:00 PM Shot — Need Dosing Advice!

Meesta Simmy

Meesta Simmy

Member Since 2019
Hello, all!

Feeling so much frustration and anger. I thought by going to 1.0 units Simmy would be doing a lot better! Some days he is good (with the yellows), but I think an increase is in order. I held at 1.0 units because I heard that there is a 6-8 day cycle for dosage changes. Should I go to 1.25?

I am unemployed currently, so I have time, but I want to get him regulated so that when I do find work again, he will be okay with reduced home testing as I will be at work.

Please advise.

https://docs.google.com/spreadsheet...O1EuxLij6HCFCVOv9OxwSbzQ4/edit#gid=1526124902

Thank you all very much. =(
 
How long you hold a dose depends on which approach to dosing you're using. With Tight Regulation (TR), you hold the dose 3 days/6 cycles if the numbers aren't where you want them to be. TR is the more aggressive of the dosing methods we use. Start Low Go Slow (SLGS) has you hold the dose for a week prior to increasing. In both cases, you reduce the dose when your cat drops below 50 with TR or below 90 with SLGS.

Holding a dose too long can be an issue. Your cat's body may start to treat higher numbers as the new "normal." (The technical term is glucose toxicity.) So, I would agree -- a dose increase is in order.

It looks like you have Simmie on a canned food diet. You're also testing enough to give TR a try.

If I may, I want to point out a note on your spreadsheet. You referenced that anything that is below normal range, (i.e., 50 on a human meter) is a hypo. That's not exactly correct. When we refer to "hypo" we are actually referring to a symptomatic hypoglycemic episode. If a cat isn't exhibiting symptoms, you're seeing low numbers. That doesn't mean you want to let your cat sit in numbers in the 40s.There's a very small margin of safety between low numbers and symptomatic hypoglycemia and I know I would want you to use some HC food to get your kitty out of low numbers so you can breath easier.

 
Sienne and Gabby (GA) said:
How long you hold a dose depends on which approach to dosing you're using. With Tight Regulation (TR), you hold the dose 3 days/6 cycles if the numbers aren't where you want them to be. TR is the more aggressive of the dosing methods we use. Start Low Go Slow (SLGS) has you hold the dose for a week prior to increasing. In both cases, you reduce the dose when your cat drops below 50 with TR or below 90 with SLGS.

Holding a dose too long can be an issue. Your cat's body may start to treat higher numbers as the new "normal." (The technical term is glucose toxicity.) So, I would agree -- a dose increase is in order.

It looks like you have Simmie on a canned food diet. You're also testing enough to give TR a try.

If I may, I want to point out a note on your spreadsheet. You referenced that anything that is below normal range, (i.e., 50 on a human meter) is a hypo. That's not exactly correct. When we refer to "hypo" we are actually referring to a symptomatic hypoglycemic episode. If a cat isn't exhibiting symptoms, you're seeing low numbers. That doesn't mean you want to let your cat sit in numbers in the 40s.There's a very small margin of safety between low numbers and symptomatic hypoglycemia and I know I would want you to use some HC food to get your kitty out of low numbers so you can breath easier.
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Sienne and Gaby,

Thank you for your response!

His AMPS (what does this stand for, BTW?) was 302. I gave him 1.25 units (pic attached).

The results have been at 9:00 AM (315), 11:00 AM (211), and 1:00 PM (145). He received 1/4 can of the same cat food at 1:20. I can test again at 3:00 PM and 5:00 PM and 7:00 PM. I will likely not be able to test again until 12:00 AM. I plan to give him 1.25 for his PM shot and then a 1/4 can of food at 10:00 PM.

The spreadsheet was shared with me and I did not make any imputs to the Range Numbers.

What is the ultimate goal (besides remission) for regulation? To get all of his BG tests under a certain number?

What is a considered a full curve? Every 2 hours between shots?

https://docs.google.com/spreadsheets/d/1eG07abtmGdYwYdh0IxO1EuxLij6HCFCVOv9OxwSbzQ4/edit?usp=sharing

Thanks again!

James
 
Here is the 1.25 unit (I hope). The rubber stopper curves up on one side... : (
 

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I'm really new, but finally found something I can chime in on, so I will! :woot:

Meesta Simmy said:
His AMPS (what does this stand for, BTW?) was 302. I gave him 1.25 units (pic attached).
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This is AM blood glucose test pre-shot.

Meesta Simmy said:
What is a considered a full curve? Every 2 hours between shots?
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I did a curve yesterday on my Boris, and we checked every 2 hours for 12 hours because we inject 2x a day. Unfortunately, I think he was bouncing, and it was a crazy day (and night)!
 
Meesta Simmy said:
What is the ultimate goal (besides remission) for regulation? To get all of his BG tests under a certain number?
Click to expand...

I would say that keeping them in the green/low blue zone is a great target if they refuse to go into remission! At least that was my goal with Jones.


Meesta Simmy said:
What is a considered a full curve? Every 2 hours between shots?
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Every 2 hours for 12 hours or every 3 hours for 18 is classed as a curve. I used a combination of the two depending on what Jones was doing.

I agree with Sienne that you could do TR and if you are opting for that method it will give you the guidelines for increases/decreases in doses.

Meesta Simmy said:
Feeling so much frustration and anger.
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Take a deep breathe. This is a marathon not a race and keep in mind that insulin is a hormone....so doesn't work like conventional medication where dose x get you y outcome. Every day is different and every cat is different (ECID).

You have cd in the dose for today but I would say that 1.25u (if that is correct) looks like progress.
 
Tracey&Jones (GA) said:
I would say that keeping them in the green/low blue zone is a great target if they refuse to go into remission! At least that was my goal with Jones.




Every 2 hours for 12 hours or every 3 hours for 18 is classed as a curve. I used a combination of the two depending on what Jones was doing.

I agree with Sienne that you could do TR and if you are opting for that method it will give you the guidelines for increases/decreases in doses.



Take a deep breathe. This is a marathon not a race and keep in mind that insulin is a hormone....so doesn't work like conventional medication where dose x get you y outcome. Every day is different and every cat is different (ECID).

You have cd in the dose for today but I would say that 1.25u (if that is correct) looks like progress.
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Hi Tracey!

Thanks for your response!

What do you mean by "cd" in the dose? Was my dose less than 1.25?
 
learjetta said:
I'm really new, but finally found something I can chime in on, so I will! :woot:



This is AM blood glucose test pre-shot.



I did a curve yesterday on my Boris, and we checked every 2 hours for 12 hours because we inject 2x a day. Unfortunately, I think he was bouncing, and it was a crazy day (and night)!
Click to expand...

Thank you so much. :D
 
Wow, his numbers are dropping... 98 @ 5:00 PM! I know I'm doing the tight regulation, at what reading should I NOT give him the 1.25?
 
Meesta Simmy said:
What do you mean by "cd" in the dose?
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I saw cd vs. 1.25u ...now I see 1.25units!


Meesta Simmy said:
should I NOT give him the 1.25?
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The answer kind of depends.

Can you stay up and test? Are you able to stall if needed and be able to give his AM shot a little later if needed? Do you have some HC and MC food around if needed?

I would see if I could get a +11 if possible and then see if he is going up at PS or if he is still going down.
 
Tracey&Jones (GA) said:
I saw cd vs. 1.25u ...now I see 1.25units!

The answer kind of depends.

Can you stay up and test? Are you able to stall if needed and be able to give his AM shot a little later if needed? Do you have some HC and MC food around if needed?

I would see if I could get a +11 if possible and then see if he is going up at PS or if he is still going down.
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Hi. He just tested at 87!!!

Yes, I can stay up late. Yes, I can his AM shot a little later.

I'm assuming HC is high carb... Yes, I have Friskies in sauce/gravy. What is MC? What should I do?
 
Meesta Simmy said:
What is MC? What should I do?
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MC is mid carb, you can mix some of your low carb and high carb together to get MC.

He is still dropping, can you stall for 20 mins, don't feed and test again? See if he is at the end of the cycle or rising. Change your post title include the statement Stalling...looking for dosing advise.

ETA: I am just leaving work, so will try to check in again as soon as I can.
 
Tracey&Jones (GA) said:
MC is mid carb, you can mix some of your low carb and high carb together to get MC.

He is still dropping, can you stall for 20 mins, don't feed and test again? See if he is at the end of the cycle or rising. Change your post title include the statement Stalling...looking for dosing advise.

ETA: I am just leaving work, so will try to check in again as soon as I can.
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I will stall and test again @ 7:30. Please don't endanger yourself if you are driving! Thank you.
 
Meesta Simmy said:
Tested @ 7:30 --- 83!
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Ok. Well we can stall another 20 as he is flat with meter variance. I am not familiar with your meter...is that a human meter? Or we can make a decision. If at all possible I would stall again. That means we are moving his morning shot back as well. If not possible we can give him the full dose and monitor like crazy. Which given that you still getting to know his patterns I am leaning against.

We can give BCS (Big Chicken Shot) so a half dose.

Or skip the shot and wait till tomorrow.
 
How long are you able to stall? Can you test again in 20 minutes without causing problems for tomorrow's shots (since they have to be 12 hours apart)
 
Tracey&Jones (GA) said:
Ok. Well we can stall another 20 as he is flat with meter variance. I am not familiar with your meter...is that a human meter? Or we can make a decision. If at all possible I would stall again. That means we are moving his morning shot back as well. If not possible we can give him the full dose and monitor like crazy. Which given that you still getting to know his patterns I am leaning against.

We can give BCS (Big Chicken Shot) so a half dose.

Or skip the shot and wait till tomorrow.
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I will stall and retest at 8:00 PM. I am using a human Reli-On Prime Compact. I will skip his PM dose and test as every 2 hours until I pass out. I'll update w/ 8:00 PM test and then feed him.
 
Meesta Simmy said:
I will stall and retest at 8:00 PM. I am using a human Reli-On Prime Compact. I will skip his PM dose and test as every 2 hours until I pass out. I'll update w/ 8:00 PM test and then feed him.
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No need to test that much if you skip...his numbers will go up as soon as you feed.

Stall and test at 8 and let us see where he is at before deciding.
 
Poor Simmy.

Ok so he is coming up.

So how brave do you feel? Want to shoot the full dose? I will be around to keep an eye on you. Have lots of testing supplies? Have no need of sleep?

Or do you want to play it safe and do a BCS?

Or if you want we can skip.

If it was me I would at least give a BCS.
 
OK.....your choices are to Skip the shot.....expect the numbers to be high again by AM but there's no chance of going too low

Go ahead and shoot the scheduled dose....Get a +1 and +2 so if you need to intervene, you can do it early (and be ready and willing to stay up as long as necessary)

Give a BCS....which will NOT guarantee he won't go too low tonight because the depot is still in play, but it lessons the chance slightly....but you'd still want to get a +1 and +2 and go from there.
 
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Okay, so he's eating approximately 2.25 ounces of food (half can). He walked away a few times, which was surprising. He was hungry and meowing for food. He's finishing up his food now.

Since he didn't eat with urgency, I'm apt to skip the shot entirely and wait until morning and do testing when I can — incredibly awful timing as my friend drove 3 hours to visit me. He understands, but I feel very badly.

Here's what I can accommodate:

I can start testing again at 10:00 (we're both starving and need to get dinner).

Tracey votes BCS.

What would you personally do, Chris?
 
I want to nail this down. I will do a BCS and then test him at 10:30 and every hour until 2 and then 4. Since Lantus is long lasting, he will be safe until I get home at 10:30/11:00?
 
Just a note. Since we stalled by 1 hour you will need to shoot a half hour later tomorrow morning. So usual shot is at seven...you would shoot at 730. On Saturday you can shoot your regular 700 am shot. Hope that makes since.

Also, you should put notes in your spreadsheet that you stalled.
 
@Tracey&Jones (GA)

I decided to go w/ 1.25 units because I want to do right by Simmy. The shot was given @ 9:11 PM.

10:00/+1 = 262

What time would I shoot tomorrow AM?

Also, I attached an image of the shot... Does that look like 1.25 to you?
 

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Meesta Simmy said:
What time would I shoot tomorrow AM?
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You have 2 choices.....either adjust by 15 minutes per cycle, or one 30 minute adjustment per day.

So if you shot at 9pm tonight (rounding to make it easier for me), you could either shoot at 8:45am/ 8:30pm, 8:15am/8:00pm, 7:45am/7:30pm, 7:15am/7:00pm

OR

9pm tonight, 9am/8:30pm, 8:30am/8:00pm, 8:00am/7:30pm, 7:30am/7:00pm
 
How is Simmy doing this morning? How about you Jim? Sleepy?


So it looks like you shot at 9 AM this morning so you can shoot at 8:45 tonight if you wanted and then 8:15 tomorrow morning.
 
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