7/23 Max AMPS+2 521+6 327 +10 484 Shot late

Today is our first day of Lantus switched from Vetsulin 6 units bid. Vet ordered 2u bid to start but I gave 4u. I’m still anxious about how much he should be on and I’m still learning how this all works. Max was diagnosed 1 month ago and we’ve been on Prozinc and then Vetsulin. I normally give his insulin at 6 am but was late and started at 7:30 am. How can I get back on the 6:00 am/pm regimen? I’m so worried he’s going to either be too high or too low. Yesterday’s thread and our first post. https://www.felinediabetes.com/FDMB/threads/new-member-need-help.250121/#post-2822878

 

Welcome. You can shoot 15 minutes early each cycle or 30 minutes early every 24 hours. You were increasing so quickly. I’m glad you took the dose down. Are you going to follow TR?

 

Honestly I’m still trying to figure it all out. The first vet had Max on a dose too high and increased and switched things quickly. Things got worse instead of better. A couple of people have advised me to start with 4 or 5 units instead of 2u because he was on such a high dose of Vetsulin. I gave the 4u this morning but Max is such a unpredictable cat it just makes me really nervous going outside of what the vet told me to do. I do know everyone here has helped so much so I’m trying to get comfortable with it all. I don’t know what I should do.

 

I just read your previous post to see who was advising you. Here’s the link for continuity.
https://felinediabetes.com/FDMB/threads/new-member-need-help.250121/#post-2822878

Marje is the best! I would listen to her. She knows more about fd than most vets put together. She helped me with my Max. Love the name, lol. Give the depot time to build and take your time to decide on the method you want to start using.

 

Yes she is the best! She’s been very helpful to me. Have you had to go against what you’re vet advised though? I guess I’m just not used to that.

 

Not exactly. I have a fabulous vet who is a boarded diplomat of internal medicine. At first I didn’t follow any advice here and wasn’t testing at home. My vet had me coming for a nadir every few days. I had a lot going on at the time. I couldn’t imagine listening to strangers and now I’m one giving advice. When Max had a 60 at +7 he thought possibly remission so we took him off insulin for a few weeks. He wasn’t in remission. I started testing when I brought my meter to my vet and he handed me the needle. A testaholic was born. I started listening to advice here and sending my spreadsheet to my vet every few weeks. He told me I managed Max better than any of his clients. He showed my spreadsheet to his 3rd year vet students who spent a week with him. We were a team. He’s not big headed and a gem.

 

That is awesome! My anxiety will ease up in a little while I guess.

 

Yes. It will until you see numbers under 100. Once the fear leaves green becomes contagious. I’d print out how to handle low numbers and the dosing methods to read.

 

What tiffmaxee said, you can get back to your desired schedule by giving the shot 15 minutes early. 15 minutes early each cycle if that's easier, or 30 minutes early every 24 hours.
The dose may be too high, or too low, but either way, there are a LOT of experienced people here to help you with whatever his blood sugar decides to do!

Good luck today.

 

Normally, getting back on schedule is done as Elise (@tiffmaxee) described but if a cat is in high enough numbers and not dropping, you can take advantage of that and shoot an hour early……sometimes even two hours early but that’s after you have data and experience and numbers are high.

I’d suggest getting a +10.5 so we can see if he’s rising and you can shoot at +11. That gets you a little closer to your normal shot time and that can be made up tomorrow.

 

Well Max just threw up. He does that sometimes especially when he's hungry and I don't feed him on time. I did give him a Cerenia tab because sometimes once he starts, he will do it again. I was trying to wait and get another BG a little later so I could give his shot a little earlier. Anyway he's 484 and that's a little over +10 timing. I fed him a little now with the Cerenia and then I will give the rest before his shot. Does that sound okay? Still not sure when to give it and how much I'm giving. I have not been able to catch him in the litter box to check for ketones, but he acts okay now. https://www.felinediabetes.com/FDMB/threads/new-member-need-help.250121/#post-2822878 @Marje and Gracie

 

He is headed up and so is suggest you test at +11 if he’s ok with the testing and shoot 4u again if you are ok with that. He did ok today but we need to let his depot fill and that takes many cycles when you are starting out.

Sorry he got sick. He just might to have a very LC snack after nadir.

 

Okay Marje thanks. So I’m terrified of him dropping too low. There’s probably a small chance of that now but as it builds up that’s what worries me. I’m still reading but what is the BG number on the AlphaTrak that would require an intervention for hypo? And when is nadir usually with Lantus?

 

Because our methods of regulation are designed for human meters and there is no equivalence between human meters and ATs, there is not an “intervention number for hypos”. Although you are following SLGS and the reduction BG is 90, for TR followers, the BG where we start thinking about a higher carb food is 68 unless they are plummeting early in the cycle.

I would suggest that if and when he hits 90 in a cycle, you might want to bump up the carbs to MC but, because every cycle is different, it’s hard to make that an across-the-board statement. What we might do for 90 at +2 is different than for 90 at +10.

I don’t mean to seem to evade your question but keep in mind that symptomatic hypos rarely occur when you are testing and feeding and you have us to help. I can’t remember when that happened. The ones I’ve seen were when the testing was very lax to null and the CG was surprised when their cat started acting weird. Lower numbers in the 50s in a human meter are safe or else we wouldn’t use that BG. Many cats go lower than that on a human meter and are fine but it’s not smart to ignore a 50 unless the cat is tightly regulated and flat in the 50s and that’s “normal” for it.

Nadir is usually +6 with Lantus but every cat is different (ECID).

 

@Max & Lori I see you shot. Good job. If you shot at +11, please add that in the PMPS column so it is 524 @ +11. You will then probably need to manually color it black by using the icons in the toolbar. Let me know if you need help.

If you did shoot at +11, which would be 6:30 your time, I believe, then you would shoot at 6:30 tomorrow morning and 6 tomorrow night to be back on schedule.

 

Yes I gave the 4 units but I ended up shooting at 7 pm. Since he was throwing up earlier I wanted to make sure he kept his food down. Thank you for answering all my questions today. It’s just all so new and so much at once to take in and understand but I will get there.

 

Give yourself a break. This is overwhelming to learn. Just keep asking questions and post each day.

 

Ok so that would be the PMPS at +11.5. That’s ok. If you can’t figure out how to fix it, please let me know and I’ll do it as an example. If you are interested in shooting at 6 in the morning, please post here and I’ll tell you how you can do it.

Elise is spot on. Just ask questions and be patient with yourself. We are here to help and we’ve all been through this hundreds and hundreds of times.

 

I have no idea how to fix the spreadsheet. So I’m glad for you to do it if you have time. I think I will just make my shoot time 7. No big deal.

 

Shot time is up to you. I can help you with it any time. I’ll fix the SS for you