7/4 Farine PMPS 320, +5 146 : Help with first curve please!

[kimouette]

Hello everyone,

Here's Farine's spreadsheet again :
https://docs.google.com/spreadsheet/ccc ... hZ1E#gid=0

Alain is doing Farine's first curve on Lantus (switched from Caninsulin to Lantus).
At first we were worried about Farines BG levels because they were not dropping (depot was building I guess), but then, as you will see on her spreadhseet, the numbers started dropping +3 after PM injection. Alain went to bed but was too worried about that drop, he could'nt sleep. So he tested Farine in the middle of the night and the numbers dropped again 146 at +5.

I have to anticipate on this one... what could be "concerning values" for the next AMPS (that will occure in 5hours)? I know we usually have to keep the same dosage for the first 3 days, and I read the documents about lowering or increasing the dosage, but since this is Farine's first day on Lantus I wanted to know what BG ranges could tell us to increase or decrease insulin ?

Like I said, when she's stable (or when we know when nadir occures)I think we'll be able to answer this kind of question, but for a first day/ first curve, I am not 100% sure of what we should do if we see a normal to low value in the morning...

Thanks for your help!

 

[Dyana]

Re: 7/4 Farine PMPS 320, +5 146 : Help with first curve plea

I would try to get another test in an hour or two. Also, do a test at about +10 or +11 and post again, so we can see where Farine is headed.

 

[KarensPoe]

Re: 7/4 Farine PMPS 320, +5 146 : Help with first curve plea

viewtopic.php?f=9&t=1581

That will take you to the general guidelines and protocols of Lantus. Since Farine just started Lantus, this applies:

"General" Guidelines:

Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).

Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).

Adjustments to dose are based on nadirs with only some consideration given to preshot numbers

The nadir usually occurs in the +5 - +7 of the 12 hour cycle, although every cat is different. Poe, for example, in my opinion, nadirs a little later I think, but I'm still learning and my data is still building too.

The +10 or +11 gives you an indication of where to go when you get the preshot test. I always get a +11 and I always get a +2 so I have an idea of the kind of cycle I might be looking at since I have to work.

Normal BG in cats is about 50-180, so a 146 is very nice actually.

There will be more experienced people responding soon, although with the holiday it might be a bit slower.

Hope I helped some....I'm still learning too

 

[Ann & Tess GA]

Re: 7/4 Farine PMPS 320, +5 146 : Help with first curve plea

Welcome to LantusLand, I'm glad that you held the dose. Sorry about so few replies, but it is a holiday here and not too many folks around. this should at least bump you to the top of the list for more eyes.

One housekeeping bit, could you please got to your signature and in the url address for your spreadsheet change ccc to pub? It take a very long time for others to open your SS and give advice.

 

[Sienne and Gabby (GA)]

Re: 7/4 Farine PMPS 320, +5 146 : Help with first curve plea

No worries with the drop to 146 last night. You want to stick with the 0.75u dose for now. After 5 days/10 cycles we can evaluate the dose unless Farine decides to take matters into his own hands and BG numbers drop below 50.

FYI: We generally consider normal BG to be between 50 - 120.