? 6/4 JELLY BELLY AMPS 147 +2 196 +6 57 +11 126? do I give evening insulin ?

[RochellenTiggs]

he was home last night with my sister not a fan no insulin given i tested at +3 in evening 5.6 (100.8) this am he is 147 (8.2) do i push a .5 unit

 

[RochellenTiggs]

he was home last night with my sister not a fan no insulin given i tested at +3 in evening 5.6 (100.8) this am he is 147 (8.2) do i push a .5 unit

He was at home while i was out last night and would not let my sister test him or give insulin I updated spreed sheet and I have test AMPS 147 @ 8 am and was wondering if I should still push .5 or .25 please advise

 

[Sienne and Gabby (GA)]

The basic rule of Lantus dosing is that you base your dose on the nadir, not the pre-shot number (unless the pre-shot number is too low to shoot). Are you comfortable shooting a 147? Will you be home to monitor and do you have strips and HC food if you need to intervene?

It also helps to keep in mind that typically, Lantus onset isn't until 2 hours after shot time. That gives you 2 hours of numbers continuing to rise. You're also feeding. Food will cause numbers to rise, as well.

If you are able to monitor, etc., you should shoot your current dose -- 0.5u.

 

[RochellenTiggs]

The basic rule of Lantus dosing is that you base your dose on the nadir, not the pre-shot number (unless the pre-shot number is too low to shoot). Are you comfortable shooting a 147? Will you be home to monitor and do you have strips and HC food if you need to intervene?

It also helps to keep in mind that typically, Lantus onset isn't until 2 hours after shot time. That gives you 2 hours of numbers continuing to rise. You're also feeding. Food will cause numbers to rise, as well.

If you are able to monitor, etc., you should shoot your current dose -- 0.5u.

I have already shot .25 as we are on a schedule and trying to scale back to 7 am for school tommorow and I am not confident with that much insulin and low 147 to me so I choose to do that and I was prepared to test at +2 and + 3 and then + 5 or 6 depending on numbers

 

[Sienne and Gabby (GA)]

Um..... How are you planning of shifting the time? You shot at around 8:30 this morning. Typically, you want to move shot time by 15 min at each shot or 30 min once a day. You don't have enough days to gradually move to a 7:00 AM shot time by Monday. You may need to skip Jelly's shot tonight in order to get back on schedule.

My thinking would be that you need to make a decision. You need to find a dose you're comfortable shooting twice a day. Basing the dose on the pre-shot number, which ultimately means that you keep changing the amount of the dose, is going to result in wonky numbers. It's just not using Lantus to its best advantage. If you're comfortable with the 0.25u dose, then stick with it. I don't see any note about which dosing method you're using or what you're feeding Jelly. I'm going to assume you're following SLGS. If that's the case, whatever dose you choose, you need to stick with it for a week. (If you're following TR, you hold the dose for 3 days. You can't follow TR if there's any dry food in Jelly's diet.) In either case, you hold the dose for the requisite number of days unless a dose reduction is indicated. It would help if you put a note in your signature regarding which dosing method you're using.

 

[RochellenTiggs]

The basic rule of Lantus dosing is that you base your dose on the nadir, not the pre-shot number (unless the pre-shot number is too low to shoot). Are you comfortable shooting a 147? Will you be home to monitor and do you have strips and HC food if you need to intervene?

It also helps to keep in mind that typically, Lantus onset isn't until 2 hours after shot time. That gives you 2 hours of numbers continuing to rise. You're also feeding. Food will cause numbers to rise, as well.

If you are able to monitor, etc., you should shoot your current dose -- 0.5u.

I don't think I understand nadir yet I'm looking in sticky and reading again

 

[RochellenTiggs]

I haven't been following either just advice by the people here and trying desperately to get a schedule going and where he can be ok because I can't test all day after Monday anymore and I've never had him this low and i was under impression we were working on a dose and it's been reduced because his numbers were low and I thought that was a good thing.... I'm trying to aim for 8 tonight and 7:30 am tom to shoot. He has an auto feeder and I can come home at lunch and see the first few days it would be +5 at that time and thought that was perfect timing am I completely wrong ?

Um..... How are you planning of shifting the time? You shot at around 8:30 this morning. Typically, you want to move shot time by 15 min at each shot or 30 min once a day. You don't have enough days to gradually move to a 7:00 AM shot time by Monday. You may need to skip Jelly's shot tonight in order to get back on schedule.

My thinking would be that you need to make a decision. You need to find a dose you're comfortable shooting twice a day. Basing the dose on the pre-shot number, which ultimately means that you keep changing the amount of the dose, is going to result in wonky numbers. It's just not using Lantus to its best advantage. If you're comfortable with the 0.25u dose, then stick with it. I don't see any note about which dosing method you're using or what you're feeding Jelly. I'm going to assume you're following SLGS. If that's the case, whatever dose you choose, you need to stick with it for a week. (If you're following TR, you hold the dose for 3 days. You can't follow TR if there's any dry food in Jelly's diet.) In either case, you hold the dose for the requisite number of days unless a dose reduction is indicated. It would help if you put a note in your signature regarding which dosing method you're using.

 

[Bobbie And Bubba]

Hi Rochelle , not a bad start after a NS last night.

The nadir is the lowest point the insulin take Jelly in a cycle. It is typically around +4- 7 for most kitties. As Sienne was saying the dose is based on the nadir number not the pre shot number. You have shot a 158 with 1 unit before (5/16) so today's start you could have safely shot .50 as the depot was drained some from the NS last night. But, it's all good information for you and this dance is a learning curve. What is helpful when you get a lower start number is to look back on the SS and see a comparable start number and how he reacted to it.

Don't be surprised if he goes higher today because of the NS last night and the reduced amount this AM. So, tonight you should go back up to .50 unit. That dose will get held for 3 days unless he goes too low again.

You are doing great. Keep posting and peeps here will help you. It's hard in the beginning as there is so much to learn and absorb but, we'll help you. We all got the same help when we started. Keep asking questions.

 

[Sienne and Gabby (GA)]

The nadir is the lowest number in the cycle. If you get a curve (testing every 2 hours or a mini-curve is testing every 3 hours) or even spot checks, you will have a pretty good idea of when the nadir falls. That said, nadirs can and do change. However, on average, cats nadirs are typically at certain points in the cycle. My kitty's nadir was at around +3 or +4 (except during the cycles when it wasn't).

Doing what you suggested above sounds fine! If your schedule is changing and you're nervous about the numbers, then use the 0.25u amount as your dose. It may end up not being enough insulin but the numbers will tell you if that's the case. It's generally easier on the caregiver's nervous system if you aren't worrying yourself to death that you've just given your cat too much insulin. If you're finding that you are skipping shots, then lowering the dose to a point where you're comfortable giving a shot twice a day without having to skip is a good strategy. I'd suggest putting a comment to that effect on your SS so people will understand why you reduced the dose.

FWIW, I work full time. Throughout Gabby's FD, I was working full time. I arranged my shot time so I had a couple of hours before I left for work to monitor Gabby's numbers. (I shot at 5:00.) I don't live that far from work so if I had a late meeting, I would leave, go home, give Gabby her PM shot, and go back for my meeting and was usually home by PM +2. In the mornings, if it looked like her numbers were dropping, she got HC food before I left for work. You might want to look over the sticky on whether it's possible to follow TR if your working/in school.

 

[tiffmaxee]

I know it's so hard at first. If Jelly were my cat I would do as Sienne suggested and shoot early enough to get a +2. Otherwise I would follow SLGS. thinking back to when I started I was nieve and didn't home test for the first couple of months until Max tested at 60 after 5 or 6 hours of insulin at my vet's office. He took him off insulin for a month and when we restarted, I started testing. I'm not sure I would have felt comfortable with TR at the beginning as I had to be gone for days at a time for several hours as my mom was in the hospital. There's no right or wrong here. Take it a step at a time. Whatever you decide can be changed at any time. If your sister can get to the point that she can help out it will sure help and I suspect make your choice easier. I was all alone with this dance.

 

[Marje and Gracie]

Here is Jelly's 6/3 condo.

Here is what you proposed so I still don't really understand why you reduced the dose this morning. It would have been fine to shoot 0.5u this morning and then reduce to 0.25u tonight if you were worried about shooting more and leaving tomorrow. But, you can always raise the dose back up if need be.

1. AMPS is 147 fed and shot .5 unit
2. test at +2 +3 and feed curve as he is lower
3. test at +5 make sure hes staying lower but not to low and then monitor based on that

Good plan. One point....you want to feed the curve as you have been no matter what his BG is. That means feeding him at AMPS, +1, +2 and setting up his autofeeder for +3 even if the reduced dose leaves him higher.

This morning would have been a great time to get back on your 7 a.m. shot time since you skipped last night. As Sienne said, it's fine to shoot at 8 tonight and 7:30 tomorrow morning. I would then shoot at 7:30 to Oreos night and 7 on Tuesday morning.

Have a great day. Surf, Jelly!

 

[RochellenTiggs]

Here is Jelly's 6/3 condo.

Here is what you proposed so I still don't really understand why you reduced the dose this morning. It would have been fine to shoot 0.5u this morning and then reduce to 0.25u tonight if you were worried about shooting more and leaving tomorrow. But, you can always raise the dose back up if need be.



Good plan. One point....you want to feed the curve as you have been no matter what his BG is. That means feeding him at AMPS, +1, +2 and setting up his autofeeder for +3 even if the reduced dose leaves him higher.

This morning would have been a great time to get back on your 7 a.m. shot time since you skipped last night. As Sienne said, it's fine to shoot at 8 tonight and 7:30 tomorrow morning. I would then shoot at 7:30 to Oreos night and 7 on Tuesday morning.

Have a great day. Surf, Jelly!

Thanks i hope you are ok and I wish I had scaled back but I was not sure based on numbers. I am feeding the curve and I just updated the spreed sheet hes at 196 that seems to be great i think

 

[Marje and Gracie]

Thanks i hope you are ok and I wish I had scaled back but I was not sure based on numbers. I am feeding the curve and I just updated the spreed sheet hes at 196 that seems to be great i think

Thank you. Yes...I'm good....have to peck at the keyboard but much better today.

Looks good. You have to follow your gut and you are learning. If it's not enough insulin, you can always go back up.

 

[RochellenTiggs]

That's kinda what I was thinking and I don't want him to crash while at school even with autofeeder I can't test and I thought maybe with the lower numbers and not shooting he may be ok on that amount ? However that might be wrong as I am still trying to make sense when it's a bounce or active cycle and trying to anayalze spreed sheet to understand Nardir and what my proper dose and what method I should be using tight regulation or shot low go slow it's still unclear to me

Thank you. Yes...I'm good....have to peck at the keyboard but much better today.

Looks good. You have to follow your gut and you are learning. If it's not enough insulin, you can always go back up.