7/31 Tucker- PMPS 115,+3.5 113,+4 118,+5 130

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Chris & Tucker

Chris & Tucker

Member Since 2012
Tuckers first dose of 1U resulted in this:
PMPS 349 1u
+3 165
+4.5 65 (tsp gravy)
+5.5 76
+6 47 (tblsp gravy)
+6.5 57 (tsp gravy
+7 64
+8 78 ate some LC food
+8.5 78

+11 78
AMPS 78 Crazy train ride! Now what? Good morning all! Do I shoot a lower .5U?
 
Re: Tucker- 7/31/12- amps 78

Good morning Chris! Jane here.

I only caught the tail end onf your crazy ride, but thank goodness you had Marje & Co. with you. Let me peek at your SS and get back to you on your dosing query, ok? I'm watching a number of other condos right now too, so bear with me for a few minutes of you can.

Welcome to LL, it's great to have you here!
Jane

P.S. The link to your SS isn't quite working as it ought to do - it should open a new tab for the spreadsheet, but actually it just redirects away from FDMB, and then (at least for me) it does NOT actually open your SS, so I can't see your numbers... Please have another look at that to fix it, k? I'll go to Your Thread on Health and check for your numbers.
 
Re: Tucker- 7/31/12- amps 78

Hi Chris and Tucker and welcome.

I'm not a dosing expert, but suggest modifying your first post by selecting the ? button so that people know you have a question. Normally testing below 50 for a cat means a deduction of .25 unit but since Tucker is so new, I'll wait for someone else to say whether that should be more of a deduction. Do you have the syringes with the half unit markings?
 
Re: Tucker- 7/31/12- amps 78

Good morning Jane and Wendy. Marge & Co were great!
Yes I do have the half unit markings.
The spread sheet opens for me...hmmm
 
Re: Tucker- 7/31/12- amps 78

Normally, on a newly diagosed kitty, if you get a bg test less than 50, we reduce by 0.25. But, since you had that 24 the last time you shot 1.00, and Tucker went right into lower numbers this time when you shot the 1.00, maybe you should reduce to 0.50 and see how that works out. Are you going to be home today, to monitor him, and do you have plenty of test strips and high carb food or karo?

I have to test and dose my cat. Jane, what do you think about the 0.50?
 
Re: Tucker- 7/31/12- amps 78

Dyana said:
Normally, on a newly diagosed kitty, if you get a bg test less than 50, we reduce by 0.25. But, since you had that 24 the last time you shot 1.00, and Tucker went right into lower numbers this time when you shot the 1.00, maybe you should reduce to 0.50 and see how that works out. Are you going to be home today, to monitor him, and do you have plenty of test strips and high carb food or karo? I have to test and dose my cat. Jane, what do you think about the 0.50?
Click to expand...

Thanks Dyana. Looked at the SS. Only 2 days of data on Lantus, and that dip into low greens on only 1u definitely makes me lean towards 0.5u, if Chris can monitor.
Chris, how do you feel, and how much will you be around today? Hows your stockpile of equipment and food etc.?
 
Re: Tucker- 7/31/12- amps 78

I have a meeting in less than 3 hours. Could be back in 6 hours.
I have everything I need. Tired for sure!
 
Re: Tucker- 7/31/12- amps 78

Thanks Chris. So, which (+ Hour) tests could you still get? (+1) and (+2)? And after that, the next one you could get would be (+6), or a later one? We need to know this to be able to advise you on dosing.
Jane
 
Re: Tucker- 7/31/12- amps 78

Ok. Here's what I think.

Since Tucker only just started Lantus, we have next to no data to help us estimate his nadir (lowest point in cycle) yet. Which means, if he had a decent (+2) and then you have to leave, and then he were to drop, you're not there to feed and regulate the cycle... That 4-hour block of time where you can't test seems, to me, to be too big a risk even for a 0.5u dose, since he dropped into the very low greens in the past few days a couple of times.

I would probably go for a BCS ("big chicken ****" ;-)) dose of 0.25u just so there something going into the shed and to keep your mind at rest that you didn't skip the shot completely. BUT I've also asked Dyana for input, and let's see what she thinks.

How far off your shot time are you now? AMPS was how many minutes ago? (Because technically, it's only an AMPS when it'd directly pre-shot, so the 78 is really your (+12) and the AMPS will be what you get on the test you'll need to do right before you shoot, when we've figured out the dose, k?)
Jane
 
Re: Tucker- 7/31/12- amps 78

It's been almost an hour since you tested that last 78, can you please do another test, and then post the number, before you shoot, anything.

I am agreeing with Jane regarding the BCS dose of 0.25 this morning, for the same reasons, that you will not be around during his onset, and after, and because we have so little data.

But, please post your next test number, first, before shooting, okay?
 
Re: Tucker- 7/31/12- amps 78

ChrisJ & Tucker said:
I'm 40 minutes off my shoot. bg now 90
Click to expand...

Thanks Chris. Remember to note in your SS remarks that the 78 was a (+12) and the AMPS was 90, and that you shifted shot time by stalling for 40 minutes. I'd go ahead with 0.25u if you're comfortable with that. It should be low enough that Tucker doesn't drop out too much at and after onset, so that hopefully you'll come home to a decent (+6), which I *definitely* advise you to get.

You ok with this plan?
Jane

P.S. Thanks Dyana!
 
Re: Tucker- 7/31/12- amps 78

Yes, I would go ahead and shoot 0.25, now.

When you're done, you can edit the subject line in your first post to say something like "Tucker- 7/31/12- +12 78, AMPS 90"
 
Re: Tucker- 7/31/12 +12 78, amps 90

Great. See you in an hour for the (+1), k?
And you're welcome of course!

Please remember, Chris, that your shot time has changed. Tucker's next insulin shot must happen 12 hours after the NEW shot time of this morning, ok?
Jane
 
Re: Tucker- 7/31/12 +12 78, amps 90

HI guys .. don't think we've been in tuckers condo before, so welcome from us! You got a lot of good advice here this morning so I'll just throw in that's a beautiful amps! have a great day guys!
 
Re: Tucker- 7/31/12 +12 78, amps 90

Chris, what time are you leaving? That (+1) on your SS says 79, which would indicate a bit of a drop. There's some concern that it may not be safe enough to let the cycle play out - Jill, one of our long-time advisors here, has suggested that you abort the cycle by feeding HC food, and also leaving out HC food for Tucker while you are out.

While the thinking behind advising you to shoot 0.25u is understandable and there *are* examples of where that approach would have been okay (like with our own cat, Karre), Jill is right to point out that it's most important to become data ready to shoot low numbers (under 150) - so for next time, I'll keep that in mind and we all will remember that principle, alright?

Please let us know any update, before you go!
Jane
 
Re: Tucker- 7/31/12 +12 78, amps 90

I agree with Jane. I think for safety's sake, giving Tucker some HC so you know the numbers aren't going to drop further makes good sense. If you were going to be home, it might be a different issue. Since you are going to be leaving, it's not possible for you to closely monitor the way you did last night. In fact, we really don't have a good sense of Tucker's patterns yet.
 
Re: Tucker- 7/31/12 +12 78, amps 90

Ok Tuckers +1 was 79, +2 was 68.
I have to leave for a meeting and will be back at +6. What do you think?
 
Re: Tucker- 7/31/12 +12 78, amps 90

Another drop. That's what the worry was... You'll have to "abort" this cycle by feeding HC - what have you got available?
You willl also need to leave out HC for Tucker. And the sooner you can be back to retest, the better, of course.

Jane
 
Re: Tucker- 7/31/12 +12 78, amps 90

He loves Gravy sensations..... Feed that ?
I have to leave. Will feed him a package of the food.
 
Re: Tucker- 7/31/12 +12 78, amps 90

Yes and leave plenty out for him so he can't run out while you're gone. I know some people like to leave a few bowls in different places when they have to leave in these type of situations too, you might like to do the same.
 
Re: Tucker- 7/31/12 +12 78, amps 90

Nice catch, Jane. I was waiting for the +6 since I missed the early morning excitement. Glad the "early birds" were all here to help Chris out!
Recap:

AMPS 90 .25u
+1 79
+2 68 fed (HC Gravy Sensations)
+6 109

Carl
 
Re: Tucker- 7/31/12 +12 78, amps 90

Hi Jane and Carl,
AMPS 90 .25u
+1 79
+2 68 fed (HC Gravy Sensations 1 foil pack)
+6 109
+7 115 I think that looks good.
I'm going to take a 2 hr nap now, then go show houses for a couple of hours. I will be back in time for the new dose time.
Hopefully he won't keep me up all night again! Thanks all!
 
Re: Tucker- 7/31/12 +12 78, amps 90

Thanks Carl! Dyana was alert and on the ball, and pointed out the SS update. Can you keep an eye on Tucker's thread? I'm winding down my board time for the day.

Have a great rest of your day Chris. Looks like Tucker is surfing nicely. Keep vigilant, ok? And please test before leaving the house especially if Tucker will be unsupervised, ok?

Jane
 
Re: Tucker- 7/31/12 +12 78, amps 90

hello chris. nice to *meet* you! welcome to the group.
you've done an awesome job managing tucker's curve!

this morning i was unable to stay on the board to follow-up so i sent jane a note about aborting the cycle. aborting the cycle may seem contradictory to some because here in the tight regulation support group we encourage "shooting low to stay low", but in order to do it safely we must have the data to support the decision.

here's an excerpt from the STICKY: LANTUS & LEVEMIR - SHOOTING & HANDLING LOW NUMBERS on "BECOMING DATA READY" written by jojo and bunny(GA) and Y:


Let's talk specifically for Lantus and Levemir. This is about fine tuning your curves.
Are you data ready to handle a lower preshot number?

This is where the very early cycle spot checks (those +1's, +2's) and those very late cycle spot checks (the +10's, +11's) come into play. Call them the "neglected" spot checks. Everyone gets those +6 spot checks, but there is a reason to collect data in the very early and very late part of the cycle.

Say you get a preshot of 150. Well if you've collected the data on the average time it takes the insulin to start having any effect for your cat and what happens after +12, then you might see that shooting a 150 is actually very safe in your cat. Kitty will be in the 200's before the insulin starts working. You are then using the lag time (aka overlap and carryover) between shooting and effect time to your advantage.

So why the +10's and +11's? Well say you are on day 5 of a dose increase change and your storage shed is now not only full, it is overflowing... and your +10 or +11 was way higher than your preshot. Good way to stay out of trouble cause now you know you would have shot a still dropping number, not a good idea. so what is the plan then?.... keep testing, and not 2 hours later, every 20-30 minutes would be better, so you can catch the minute it turns and do not loose all your overlap. If you miss the rise and cat is way up there BG wise before you shoot, remember the number is just going to continue to rise in those hours before the insulin has a chance to kick in, and you have a roller coaster curve going rather than the flat curve that is ideal.

Also some Lantus and Levemir users notice a dip at the end of the cycle, meaning that their preshot is always a bit lower than their +10 or +11. It is important to know if your cat is one of those because if you are not raising your dose because your PS doesn't seem to call for it, yet your nadir is not so hot... this could be the reason why.

If you want to choose less important times to test, really the +8's and +9's and the +4's and +5's are the numbers that yield the least amount of important data once you have well established the nadir in your cat. Yes, get them here or there on spot checks, but do not forget to get the "neglected" spot checks... the very early and very late parts of cycle. They are more useful than most realize.

Know thy cat. Be data ready to handle the situation.


"knowing thy cat" is key to shooting low preshot numbers safely. because tucker is so new to lantus, we just don't have enough data accumulated yet to safely shoot those low preshot numbers and then leave the house, but eventually you will. we also recommend monitoring closely when shooting low preshot numbers until you have a good idea of what kitty will do.

recap:

PMPS 349 (1u) - first shot of lantus
+3 165
+4.5 65 (tsp gravy)
+5.5 76
+6 47 (tblsp gravy)
+6.5 57 (tsp gravy
+7 64
+8 78 ate some LC food
+8.5 78
+11 78
+12 78

(+12.75 or +13?) AMPS 90 (0.25u)
+1 79
+2 68 fed (HC Gravy Sensations 1 foil pack)
+6 109
+7 115


i don't know if tucker's initial starting dose of lantus was set too high or if tucker is one of those kitties who experienced a marked response during the first few cycles. some lantus/levemir kitties will drop unusually low sometime over the first few cycles and we don't know why, but it's the reason behind the suggestion to test at shot times as well as at +3, +6, and +9 for the first few days.

because of the cumulative nature of lantus (one dose building upon the next), i think it's a good idea to shoot less than 1u tonight. ideally, you want to find a dose you'll be able to shoot every 12 hours without it dropping him too low.

please post whatever spot checks you get today and ask for thoughts before shooting tonight.



hope you were able to fit in a nice nap...
 
7/31 Tucker AMPS 90;+1 79;+2 68;+6 109;+7 115;+9 94 newbie d

Today:
(+12.75 or +13?) AMPS 90 (0.25u)
+1 79
+2 68 fed (HC Gravy Sensations 1 foil pack) Had to abort due to meeting schedule
+6 109
+7 115
+9 94
PMPS 115 (+12)
Hello all! I'm now scheduled for a dose at 6:45 EST I decided on another 0.25U . You think that is OK ?
Yesterday was a rollercoaster. 1st Dose of Lantus was yesterday in the PM at 1U.
Today AM at .25U had to abort.
 
Re: Tucker- 7/31/12 +12 78, amps 90

Chris, could you change your subject line to this?
7/31 Tucker AMPS 90;+1 79;+2 68;+6 109;+7 115;+9 94 newbie dose question

Keep the question icon. This should get the attention of a dosing expect. What do you mean by PMPS 115? Did you get this test at +12? But you haven't shot yet? Usually PMPS would mean you gave the shot. You are doing a fantastic job with testing!
Liz
 
Re: Tucker- 7/31/12 +12 78, amps 90

Chris,
Even though you had to put the brakes on his slide due to your meeting, it looks like the rest of the cycle went really well. Looks like you already shot the .25U? In that case, I agree completely! :lol: No, I think it's good. At this point, your primary "job" is data collection so that you can figure out things like what the dose should be, and when his onset and nadir tend to happen. All data is useful in the big picture.

Carl
 
Re: Tucker- 7/31/12 +12 78, amps 90

Hi Anne and Carl,
Yes, I tested Tucker and it was 115 at +12 , which is when I dosed him with .25U . Is that not also the PMPS?
 
Re: Tucker- 7/31/12 +12 78, amps 90

Yes, that's right Chris. I think the confusion may have been that we weren't sure if you had given the shot yet or not, but then I saw that you had put .25 on the SS probably just before I opened it. PMPS (pre-shot) is right if you gave the shot. If you ever get a +12 you don't shoot insulin into, you would list that as PMBG (blood glucose). That lets people know you are holding off on shooting, or that you skipped the shot.

Carl
 
/31 Tucker AMPS 90;+2 68;+7 115;+9 94; PMPS 115 newbie dose

OK Carl, that makes sense to me know. Thanks. I hope I don't have another night like last! I'm holding off his fresher evening meal for a few more hours , just in case.
 
Re: Tucker- 7/31/12 +12 78, amps 90

If you've already shot, then it is PMPS. Your subject line could look like this, if you still have a question:
7/31 Tucker AMPS 90;+2 68;+7 115;+9 94; PMPS 115 newbie dose Q

Will that fit? I think the 0.25u is fine. Normally, we would recommend that you wait for a pre-shot value of 150 for a cat without a lot of data and wait until you see a rising number. This is called a stall and you wouldn't feed until you're ready to give the shot. Be sure to get a +1 and +2. Good job!
Liz
 
Re: Tucker- 7/31/12 +12 78, amps 90

ChrisJ & Tucker said:
OK Carl, that makes sense to me know. Thanks. I hope I don't have another night like last! I'm holding off his fresher evening meal for a few more hours , just in case.
Click to expand...

I hope you have a nice peaceful night Chris! Last night was sort of a baptism by fire for you. Keep track in your head of what Tucker eats and when, and that will help make sense of the numbers you get tonight as you go forward.

This will all get less overwhelming with each day that passes,
Carl
 
Re: Tucker- 7/31/12 +12 78, amps 90

I've tried changing the subject line, but it onlky does for that one thread. It doesn't change the whole thread. When do you start a new thread? ...and do you somehow close the old one? Am I missing an instruction page I can follow? Thanks...
 
Re: Tucker- 7/31/12 +12 78, amps 90

OH, and I wanted to mention.... the tips Liz gave you for updating your subject line? If you go back to your very first post in this thread, you can click on "edit" to the top right of the window you type in. Then you can change your subject line as the day goes on, to put the latest numbers, or to indicate you have a question or need help. That updates the Subject Line for the entire thread, and that's the one we all see when we are looking at the index page. It's an easy way to get eyes on your thread quickly. You've seen how busy this forum is, and sometimes a thread that is only an hour or two old can be "pushed" down the page due to all the other newer threads.

Carl
 
Re: Tucker- 7/31/12 +12 78, amps 90

I like the conservative dose. I'm hoping you like it even more and you can get some sleep tonight. Generally, though, we suggest that you don't shoot if your pre-shot # is below 150 until you have more data. While I hope it's not a long night, it could be.

Just to consolidate some of the feedback you're getting re. subject line, you've the the info correct for your first shot of the day (AMPS). As the day progresses, we change the subject line to include the recent test data. This allows those of us who scan the board and look for new members, the need for potential guidance, etc. to see what's going on without having to open every thread. (We call each thread a "condo.") In order to change what is visible on the board, you need to edit the subject line in your first post of the day.

The convention is:

Date Cat's Name AMPS-#, +time-#, +time-#.....PMPS-#​

So, Iike Liz suggested, your current subject line should read:

7/31 Tucker AMPS 90;+2 68;+7 115;+9 94; PMPS 115​

If you run out of space, you can delete the numbers (e.g., if your in the evening cycle, you can delete the AM numbers).
 
Re: 7/31 Tucker AMPS 90;+2 68;+7 115;+9 94; PMPS 115

Thanks all for the lesson.....I'm learning.

Summary Today:
(+12.75 or +13?) AMPS 90 (0.25u)
+1 79
+2 68 fed (HC Gravy Sensations 1 foil pack) Had to abort due to meeting schedule
+6 109
+7 115
+9 94
PMPS 115 (+12) used .25U
 
Re: 7/31 Tucker AMPS 90;+2 68;+7 115;+9 94; PMPS 115

It's a lot to learn and you are doing great! We keep a notebook with all of Zener's info: BGs, food, meds, weight, vomit, pee, poo, any weird behavior, whatever else we think is important. Last week the vet said "keep an eye on him" and I thought "I could tell you every 0.05 oz of food he's eaten for the last year, yes, I'll keep an eye on him". :lol: :lol: I think you will need to write stuff down in a somewhat organized way if you want to keep track of stuff and it will be helpful to keep track.
Liz
 
Re: 7/31 Tucker AMPS 90;+2 68;+7 115;+9 94; PMPS 115

Chris --

I was editing my post and our messages crossed. Here's what I added:
Generally, though, we suggest that you don't shoot if your pre-shot # is below 150 until you have more data. While I hope it's not a long night, it could be.
Click to expand...

In a post above, Jill copied over information regarding becoming "data ready." I'd encourage you to go back and re-read that information. I know there's a huge amount to absorb. While shooting low can be a good thing, we are balancing both your cat's safety and your need for sleep. Not everyone can stay up every night to monitor their cat's BG numbers.
 
Re: 7/31 Tucker AMPS 90;+2 68;+7 115;+9 94; PMPS 115

Chris

Jill left you some great info on this condo today; I know you had to show houses so not sure if you had a chance to read it?

I know you want to keep momentum going but it would have been a better idea to stall and let this number rise, or if you couldn't stall, to skip. And skipping probably would have been the better choice considering the night you had last night and that Tucker is still cruising along in normal numbers. Because we don't have much data, we don't really know what dose is going to be the fitting dose for Tucker so it's best to be a little more conservative.

However...now that the insulin is in, we need to be vigilant. Could you please get a +1 and +2 and post for us? Thank you so much :-D
 
Re: 7/31 Tucker AMPS 90;+2 68;+7 115;+9 94; PMPS 115

OK, I'm oficially confused. Now remember, we're talking about just starting Tucker on Lantus. Today is only dose #3.
This morning his AMPS was 90, after low #s the night before and I was told to dose him .25U
His PMPS this eve was 115 , and I should have waited?
Am I not trying to build up the resrve the first 5-7 days?
 
Re: 7/31 Tucker AMPS 90;+2 68;+7 115;+9 94; PMPS 115

I have been corrected. I should not have told you to shoot if his BGs were below 150, as you don't have enough data collected yet, on what numbers the insulin is taking him to in the mid cycle, etc.

The 115 is a fine number to shoot, if you had lots of data to look back on, to and see how he did the last time you shot the same number. We're just trying to be safe.
 
Re: 7/31 Tucker AMPS 90;+2 68;+7 115;+9 94; PMPS 115

Thanks Dyana. I thought I was going crazy.
Summary Today:
(+12.75 or +13?) AMPS 90 (0.25u)
+1 79
+2 68 fed (HC Gravy Sensations 1 foil pack) Had to abort due to meeting schedule
+6 109
+7 115
+9 94
PMPS 115 (+12) used .25U
+1 110 Tucker decided to eat his dinner. About 1 1/2 oz of FF
+2 107
 
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