7/26: Dexter 218 @AMPS, need dosing guidance

Discussion in 'Lantus / Levemir / Biosimilars' started by Katie & Dexter, Jul 26, 2021.

  1. Katie & Dexter

    Katie & Dexter Member

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    Jul 3, 2021
    https://felinediabetes.com/FDMB/posts/2824653/

    Looking for dosing guidance this morning. Will be my first time adjusting the dose. Since I started home testing last week, he's been low enough to skip his dose. Thank you in advance for your help!
     
  2. Bandit's Mom

    Bandit's Mom Well-Known Member

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    Oct 18, 2019
    Hi Katie,

    Welcome to the Lantus forum! :)
    Just to confirm what I've understood from your previous post:
    • Dexter has been on Lantus since May 2021
    • His dose was upped to 1.5U twice a day from Jun 20, 2021
    • You started home testing from July 23, 2021
    From your previous post, I see that @Sienne and Gabby (GA) suggested taking his dose down to 0.5U.

    Will you be able to monitor him today if you shoot?
     
  3. Katie & Dexter

    Katie & Dexter Member

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    Jul 3, 2021
    Hi!

    Yes, you are correct on the information from the previous post. I do have to go into work this morning, so I won't be home to monitor until this afternoon. I have to go in to work in 1.5 hours and won't be able to get back until my lunch (which would be 6 hours from now).

    Thank you!
     
  4. Bandit's Mom

    Bandit's Mom Well-Known Member

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    Oct 18, 2019
    Then let us be conservative and start with 0.25U as suggested by @Chris & China (GA).
    Can you get a test before you leave for work and again at lunch?

    Hopefully more experienced members will weigh-in on dosing during the day.
     
  5. Bandit's Mom

    Bandit's Mom Well-Known Member

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  6. Katie & Dexter

    Katie & Dexter Member

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    Jul 3, 2021
    Ok, sounds good! Yes, I can get a test in before I leave this morning and another one at lunch.
     
  7. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    Leave food out. When you can you might want to get an auto feeder. They are good for while away or asleep. Let’s see the tests you get before you leave and until pmps to see about dosing. I agree with the ,25 since you won’t be home until lunch.
     
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  8. Katie & Dexter

    Katie & Dexter Member

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    Jul 3, 2021
    Dexter was at 187 @ +2. I'll update again during my lunch.
     
  9. Katie & Dexter

    Katie & Dexter Member

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    Jul 3, 2021
    164 @ +6
     
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  10. tiffmaxee

    tiffmaxee Well-Known Member

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    He’s fine until pmps.
     
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  11. Katie & Dexter

    Katie & Dexter Member

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    Jul 3, 2021
    Dexter is at 83 @ PMPS
     
  12. Katherine&Ruby

    Katherine&Ruby Well-Known Member

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    Hi Katie, I see you haven't been giving Dexter shots when he's below 100 and then he goes high. 83 is a safe number to shoot. Does Dexter cooperate well with testing? Could you get a +1 and +2 test? Do you have a hypo kit of extra test strips and medium and high carb food on hand? If yes, I would give him the shot and monitor him closely.
     
  13. Katherine&Ruby

    Katherine&Ruby Well-Known Member

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    Oct 8, 2020
    This all depends on your comfort level, too. We generally tell people new to testing not to shoot a number so low, but I worry that if you skip again it will keep you in the same loop of having higher numbers in the morning.
     
  14. Katie & Dexter

    Katie & Dexter Member

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    Jul 3, 2021
    I stalled for 20 minutes and he's now at 72.
     
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  15. Katherine&Ruby

    Katherine&Ruby Well-Known Member

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    Oct 8, 2020
    I would skip the shot if he keeps dropping.
     
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  16. Katie & Dexter

    Katie & Dexter Member

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    Jul 3, 2021
    Should I stall again to see if it keeps dropping or go ahead and skip? If stalling, for another 20 minutes or longer?
     
  17. Katie & Dexter

    Katie & Dexter Member

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    Jul 3, 2021
    I do have a hypo kit with extra test strips, but I haven't had a chance to grab some high carb food yet. (Are there recommendations for what to use for the high carb food?) He's starting to get used to the testing and I'm getting better at being able to get it done more quickly without having to poke him multiple times, but after too many he does start trying to hide and avoid me.
     
  18. Katherine&Ruby

    Katherine&Ruby Well-Known Member

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    Oct 8, 2020
    If you have room in your schedule to stall a bit more then you can do so, but keep in mind that if you shoot 40 mins later tonight you will have to shoot 40 mins later tomorrow morning.

    Do you have honey or Karo syrup? We usually recommend Fancy Feast beef in gravy as a high carb option because it keeps the cat up longer than honey/Karo.
     
  19. Katie & Dexter

    Katie & Dexter Member

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    Jul 3, 2021
    I do have karo syrup. Because of work, I don't have as much flexibility in the morning, especially if I end up needing to stall at that point too.
     
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  20. Katherine&Ruby

    Katherine&Ruby Well-Known Member

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    Oct 8, 2020
    Looks like he's doing a slide downward. Lots of kitties do this--my Ruby went from 321 this morning to 114 at PMPS, but I've got more experience than you to know I can still shoot a dropping number. Lantus is very good at keeping lower numbers flat and steady, so if you shot it might still be ok, but you'd have to watch him vigilantly. Since you're still so new to this, I'd skip so you can resume your normal schedule in the morning.
     
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  21. Katie & Dexter

    Katie & Dexter Member

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    Jul 3, 2021
    Ok, thank you for your help!
     
  22. Katsallday

    Katsallday Member

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    I'm just curious I'm not an advisor in anyway, but how often does he eat?
     
  23. Katie & Dexter

    Katie & Dexter Member

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    Jul 3, 2021
    I put food out for him 2x/day. He usually eats about 1/2 right away, but I'm not home throughout the day to monitor how frequently he's going back to snack/finish. With his more recent lower numbers, I've been leaving some out for him overnight, as well. For all of the feedings, I've been leaving the food out until 2 hours prior to pre-shot. I've gotten a lot of differing information from different vets and resources about the best options for feeding, so any additional information anyone has regarding this is helpful!
     
  24. Katsallday

    Katsallday Member

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    So this is what happened with my cat and of course every cat is different and I am not an advisor at all here. However my vet told me to strictly feed only two times a day and push his insulin no matter what and and to never home test. Thankfully I found this site quickly and was able to start testing within 2 days. My cat is in remission now thanks to the FDMB but I have noticed that his blood glucose gets higher when he doesn't eat. I switched to feeding him every 6 hours and now I can maintain his blood glucose around 80 without insulin. At first I really wanted to stick to the vets recommendation of only feeding him twice a day because he is quite large however it just didn't work for his diabetes. Now instead I exercise him more and feed him more often :)

    Please remember I'm not an advisor and I only dealt with diabetes for a month. My situation could be different and I could just be lucky?
     
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  25. Katie & Dexter

    Katie & Dexter Member

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    Jul 3, 2021
    Does your cat eat all their food right away or do you leave it out for them to eat on their own time? And do you use an auto-feeder?
     
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  26. Katsallday

    Katsallday Member

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    May 16, 2021
    He eats it slowly, when he stops eating I usually stir the food up a bit and he grazes more. I'm looking into getting an auto feeder but for now I'm the food robot lol. My boy has never been big on eating even though he's 19 lbs so it's a full time job keeping him eating!
     
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  27. Bandit's Mom

    Bandit's Mom Well-Known Member

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    Oct 18, 2019
    @tiffmaxee do you think Katie needs to shoot a lower dose (like 0.10U or a drop) to be able to shoot twice a day?
     
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  28. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    Yes. Let’s try 0.1.
     
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  29. Bandit's Mom

    Bandit's Mom Well-Known Member

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    @Katie & Dexter When you first use a syringe, push the plunger all the way in to see if it lines up with the printed zero line. A lot of syringes have their markings way off and that affects the accuracy of the dose. And with smaller doses like Dexter is on, every little bit makes a big difference.
     
  30. Katie & Dexter

    Katie & Dexter Member

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    Jul 3, 2021
    Are there syringes that would make this easier to do? That's going to be challenging to eyeball with the ones I have. Also, will this depend on his numbers and will you likely need more than just the AMPS? I don't have a lot of extra flexibility to stall before shooting because of a meeting I have to be at tomorrow morning.
     
  31. Bandit's Mom

    Bandit's Mom Well-Known Member

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    Oct 18, 2019
    Which syringes do you use? Are they 30 unit syringes with half unit markings?

    If he is below 200 at AMPS, it's better to skip. What time is your AMPS? I will try and be around then.
    It's hard to tell at this point, but it looks like Dexter might need some insulin. And not for long.
     
  32. Katie & Dexter

    Katie & Dexter Member

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    Jul 3, 2021
    Yes, the syringes are 30 unit with half unit markings.

    I shoot at 6am (I'm in pacific timezone).
     
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  33. Bandit's Mom

    Bandit's Mom Well-Known Member

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    Oct 18, 2019
    OK. That 6:30pm for me. I will watch out. Let's see how he does tonight and where he is at AMPS.
     

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