? 8/16AMPS 55. Should I give insulin?

Cheryl & Jazzy

Member Since 2020
Good morning. Jazzy's numbers seemed to have been climbing. His insulin pen was 3 months old, so I switched to a new pen.
His preshot test today read 55. He's not been that low before. Not sure if I should skip insulin this morning? I'll be here to monitor his behaviour, but I'm not sure if anyone will be home to help test if needed.
Can I have some advice please?
 
If you've been stalling and didn't feed Jazzy, please re-test.

If you're following TR, you can shoot any number above 50.

Just an FYI, if you are following TR (I'm assuming you're doing so since you would have missed a lot of reductions if you were using SLGS), you can reduce the dose if your cat is in normal numbers for a week. The issue with TR, though, is you need to get at least one spot check during both the AM and PM cycles to make sure your kitty hasn't earned a dose reduction. For example, there's a reasonable chance that Jazzy's numbers went low last night given your AMPS. So, I'm confused as to which dosing method you're using. You're getting curves, but not on a weekly basis the way SLGS would dictate.
 
If you've been stalling and didn't feed Jazzy, please re-test.

If you're following TR, you can shoot any number above 50.

Just an FYI, if you are following TR (I'm assuming you're doing so since you would have missed a lot of reductions if you were using SLGS), you can reduce the dose if your cat is in normal numbers for a week. The issue with TR, though, is you need to get at least one spot check during both the AM and PM cycles to make sure your kitty hasn't earned a dose reduction. For example, there's a reasonable chance that Jazzy's numbers went low last night given your AMPS. So, I'm confused as to which dosing method you're using. You're getting curves, but not on a weekly basis the way SLGS would dictate.
We have been doing curves, but it's usually every 2 weeks. The problem is that my husband works a ton of hours and they're always random. Sometimes double shifts as well. So since at this point in time it takes 2 of us to test him, we can only do curves when we know both of us are home. I wish I could test by myself, but so far it hasn't been successful. I've watched videos, know some of the tricks. But our cat does not care. Lol. He doesn't cooperate much. I hope to change that but so far it hasn't happened.
We get spot checks in when we can as well, it's not always at the same point in the cycle. Unfortunately there is not someone home at all hours.
 
The point, though, is which approach to dosing are you following? It's next to impossible to offer any suggestions if we don't know whether you're following TR vs SLGS. This is a link to the dosing method sticky. Please add the information to your signature.

The reason for specifying a method is that the points at which you make reductions differs. Likewise, with TR you aim to shoot lower than with SLGS. There are also differing conditions (e.g., if you are feeding any dry food) which dictate whether you can use TR. None of us want to give you poor direction so it's essential that we know what you're doing.
 
The point, though, is which approach to dosing are you following? It's next to impossible to offer any suggestions if we don't know whether you're following TR vs SLGS. This is a link to the dosing method sticky. Please add the information to your signature.

The reason for specifying a method is that the points at which you make reductions differs. Likewise, with TR you aim to shoot lower than with SLGS. There are also differing conditions (e.g., if you are feeding any dry food) which dictate whether you can use TR. None of us want to give you poor direction so it's essential that we know what you're doing.
Ok. Thanks. I thought the info was there in the signature. I'm fix it if it's not. We started with SLGS and switched to TR. Im not sure what one is better, to be honest. I've read the info a few times. I'll re read it again.
This is actually the most help I've ever gotten on this site, honestly. I'm usually trying to figure things out on my own.
Do you suggest one dosing method over another?
 
His insulin pen was 3 months old, so I switched to a new pen.

Lantus does not get old after 3 months unless it's been frozen or has been allowed to get too hot...or perhaps left out for an extended period of time.

I've used my Lantus vial for nearly a year - to the last drop. Every pen is used to the last drop as well...I've never discarded a pen due to 'age'. They are kept in the fridge in the coolest place - not the drawers, not the door...

Did you observe floaties or clouds in your pen? Was there any other reason you switched to a new pen? Just hate to see you wasting it...however, if there was a reason :)
 
I know sometimes it can be hard to get advice on here. I have found the same thing. Last week, I was the exact same situation and ended up making a terrible decision on my own. I had to own that decision, lol. But I learned from it: there are few people on here comfortable with giving advice on dosing and shooting, but they do their very best to help everyone and we are so lucky to have them here to help us.

I also learned from that day:
-it is okay to tag people when you need help/have questions.
-when stalling, in addition to the "?" make your subject line in capitals like "STALLING- NEED HELP LOWEST AMPS 55"
-responding to your thread bumps it to the top of the pile. There are so many condos here, sometimes you just need to bump it up and tag a few people to get help.

I only started consistently posting maybe three weeks ago. It is a lot of work, but I found I was getting more help as everyone has been getting to know Butters and see her progress day-to-day.
 
Lantus does not get old after 3 months unless it's been frozen or has been allowed to get too hot...or perhaps left out for an extended period of time.

I've used my Lantus vial for nearly a year - to the last drop. Every pen is used to the last drop as well...I've never discarded a pen due to 'age'. They are kept in the fridge in the coolest place - not the drawers, not the door...

Did you observe floaties or clouds in your pen? Was there any other reason you switched to a new pen? Just hate to see you wasting it...however, if there was a reason :)
It's always kept in the same spot in the fridge, on the shelf. It's never been left out. I've pushed a few air bubbles into it trying to get them out of the syringe. Since I did that, it seems to have gotten less effective. I don't know if that has anything to do with it, or if it's coincidental. I didn't think it should be expired or anything because I know everyone uses it for an extended period. I didn't throw it out, it's still in the fridge. Just thought I'd switch to see if there was any difference noted. Thanks for your reply.
 
I only started consistently posting maybe three weeks ago. It is a lot of work, but I found I was getting more help as everyone has been getting to know Butters and see her progress day-to-day.

That's the ticket Lyla! Frequent posting, updating the SS and repeatedly modifying your title WILL get the attention you're looking for and frankly entitled to...but you're right...giving advice is tricky biz...:bighug: You're responsible for someone else's beloved cat...and heaven help us all if you're the one giving the advice and it's not right...that's why we call it a 'FORUM'...hoping lots of experienced people can weigh in and give opinions and advice - it's not the law or the gospel...it's advice...and it's hopefully taken that way - it's up to every member here to READ the stickies...LEARN from other's condos and comments...and yep, it's a darn good bit of work..and we're all doing it every day...just part of the gig I guess...FD isn't an easy thing...it gets to be a routine...so we all try to do our best :D:D
 
I know sometimes it can be hard to get advice on here. I have found the same thing. Last week, I was the exact same situation and ended up making a terrible decision on my own. I had to own that decision, lol. But I learned from it: there are few people on here comfortable with giving advice on dosing and shooting, but they do their very best to help everyone and we are so lucky to have them here to help us.

I also learned from that day:
-it is okay to tag people when you need help/have questions.
-when stalling, in addition to the "?" make your subject line in capitals like "STALLING- NEED HELP LOWEST AMPS 55"
-responding to your thread bumps it to the top of the pile. There are so many condos here, sometimes you just need to bump it up and tag a few people to get help.

I only started consistently posting maybe three weeks ago. It is a lot of work, but I found I was getting more help as everyone has been getting to know Butters and see her progress day-to-day.
Thank you. I didn't know I could tag people. That's good to know. I know I should be able to give him his shot, but I'm just not comfortable doing it. I'm here alone, my husband is at work with the car. I can envision too many bad things happening and I really don't want to go through an emergency. (Just had to put our St. Bernard down last week due to osteosarcoma. It's been a very stressful month ☹️). I've only posted when I've needed help, and it wasn't really coming, so it's been a bit frustrating. I think I'll start posting more just to be seen.
 
I think I'll start posting more just to be seen.

Oh please do :) We'd love to see how you guys are doing - for a variety of reasons some people are on more during the week than during the weekends...I work all week so my time is very limited then...but I try to get on as often as I can...especially to look for newbies and people who need help...

So very sorry to hear about your St. Bernard :( It has been stressful...but take heart, your Jazzy is looking quite good!
 
Noted :)

I'm not seeing many mid cycle tests recently...would it be possible to get a few more tests during the day and night? I think you may be missing her nadir...just a thought...but seems worth trying. She's got great numbers though!
Unfortunately we haven't been able to get many mid cycle tests lately. We do them when we can tho I let my husband know that it definately needs to be done more often. Whether Jazzy likes it or he doesn't, it has to be done
 
Regarding testing...
The more you test AND give a treat, the greater the likelihood that Jazzy will get used the process. Give your kitty a reward every time you test. I would even suggest taking Jazzy to the testing spot, play with his ears, and just give him a treat. The more the expectation that something good will happen with a test, the easier it gets. Also, it really depends on what your cat considers a treat. Mine was highly food motivated. There are members who would find brushing was a treat.

The reason the spot checks are so important is that Lantus dosing is based on the nadir (the lowest point in the cycle). Based on your curves, Jazzy's cycles have been pretty flat -- which is wonderful. However, you also don't want to miss a possible dose reduction.

There are differences between TR and SLGS. I'll do my best to give you a feel for how they differ. Both methods encourage getting an AMPS and PMPS and at least one additional test each cycle -- so a minimum 4 tests per day. Regardless of which approach you use, you need to have enough data to know when Lantus onset and nadir occur and how much duration your cat is getting.
  • Tight Regulation (TR) Protocol: This is a research based approach for Lantus and Levemir that was published in a leading feline veterinary journal several years ago. It's strength is that it can get a considerable percentage of newly diagnosed cats into remission. It is aggressive. Once the depot is established, doses are evaluated every 3 days if nadirs are > 200 and every 5 days if in lower numbers. When using a human meter, dose reductions for a cat within a year of diagnosis are given when numbers drop below 50. You gradually work your way down to shooting any number above 50. For someone brand new to FD, the "post and ask for help" pre-shot number is 150. Because you can be dealing with lower numbers, more testing is often necessary. FWIW, many of us who work full time are able to still use this method. You cannot use TR if your cat is eating any form of dry food.
  • Start Low Go Slow (SLGS): SLGS was developed here. It is an approach that is applicable to a broad range of insulin types, not just the depot insulins. There is no formal research that documents the utility of the approach but many cats have achieved remission using this method. There is also far greater flexibility. Dose reductions occur if numbers drop below 90. Doses are held for a week, you run a curve, and then decide if an increase is needed. One of the issues that I often see with SLGS is that people hold the doses for too long. The "post and ask for help" number for a new member is 200. Again, people seem far more reticent to start to shoot lower numbers.
It it's not evident, my personal preference is for TR. It's what I used with Gabby. I think the instructions are far better laid out. TR was first used by the Lantus group based in Germany and that's where the research data were collected. One of the members here brought the protocol to this group. I like the science behind it. However, the approach isn't for everyone.

So that's the general perspective. With Jazzy, you're seeing absolutely wonderful numbers. There are a couple of additional aspects to TR. A dose can also be reduced if your cat is in normal numbers for a week. The mid-cycle tests would tell you if Jazzy's dose should have been reduced because it looks like Jazzy could be very close to remission. With SLGS, you would have already been reducing -- you have a lot of numbers that are below 90.

As for the social norms here, it is obviously a big forum. We can't get to know everyone. Like Sue, I work during the week and my hours routinely exceed a 40 hour week. (I can't even remember when I worked 40 hours -- it's usually a lot more.) I'm sometimes able to check in during the day. By the time I get home, I'm totally exhausted from a day of Zoom and other activities. I'm guessing it's the same for many others. I've been around a whole let less since Covid since I work in healthcare and there's been a huge demand. I do try to be here during the weekends and sometimes in the early AM. Thus, the more you post, the more people get to know you. If you post in other people's threads, they will reciprocate -- and looking at other spreadsheets can be very informative as can reading a thread that seems to be related to your cat is also helpful. Like Sue suggesting, using eat "?" icon in your subject line or indicating if you have a question or problem will get attention. Experienced members and the moderators look for that information since everyone's time is limited.
 
Please try to start a post daily only if it's to tell us Jassy ate well. We get to know your cat and that is a big plus. Or if he all of a sudden jumped on bed or played with a toy something he hasn't done in weeks. It lets us know he is starting to feel good.

Some people only post if they have a problem and we don't know what has been happening before that.

And reading other posts, you can pick up tips you might have not thought of. Like singing or humming when testing so you stay calm and cat won't pick up your nervousness.

Hope to see more from you.
 
Regarding testing...
The more you test AND give a treat, the greater the likelihood that Jazzy will get used the process. Give your kitty a reward every time you test. I would even suggest taking Jazzy to the testing spot, play with his ears, and just give him a treat. The more the expectation that something good will happen with a test, the easier it gets. Also, it really depends on what your cat considers a treat. Mine was highly food motivated. There are members who would find brushing was a treat.

The reason the spot checks are so important is that Lantus dosing is based on the nadir (the lowest point in the cycle). Based on your curves, Jazzy's cycles have been pretty flat -- which is wonderful. However, you also don't want to miss a possible dose reduction.

There are differences between TR and SLGS. I'll do my best to give you a feel for how they differ. Both methods encourage getting an AMPS and PMPS and at least one additional test each cycle -- so a minimum 4 tests per day. Regardless of which approach you use, you need to have enough data to know when Lantus onset and nadir occur and how much duration your cat is getting.
  • Tight Regulation (TR) Protocol: This is a research based approach for Lantus and Levemir that was published in a leading feline veterinary journal several years ago. It's strength is that it can get a considerable percentage of newly diagnosed cats into remission. It is aggressive. Once the depot is established, doses are evaluated every 3 days if nadirs are > 200 and every 5 days if in lower numbers. When using a human meter, dose reductions for a cat within a year of diagnosis are given when numbers drop below 50. You gradually work your way down to shooting any number above 50. For someone brand new to FD, the "post and ask for help" pre-shot number is 150. Because you can be dealing with lower numbers, more testing is often necessary. FWIW, many of us who work full time are able to still use this method. You cannot use TR if your cat is eating any form of dry food.
  • Start Low Go Slow (SLGS): SLGS was developed here. It is an approach that is applicable to a broad range of insulin types, not just the depot insulins. There is no formal research that documents the utility of the approach but many cats have achieved remission using this method. There is also far greater flexibility. Dose reductions occur if numbers drop below 90. Doses are held for a week, you run a curve, and then decide if an increase is needed. One of the issues that I often see with SLGS is that people hold the doses for too long. The "post and ask for help" number for a new member is 200. Again, people seem far more reticent to start to shoot lower numbers.
It it's not evident, my personal preference is for TR. It's what I used with Gabby. I think the instructions are far better laid out. TR was first used by the Lantus group based in Germany and that's where the research data were collected. One of the members here brought the protocol to this group. I like the science behind it. However, the approach isn't for everyone.

So that's the general perspective. With Jazzy, you're seeing absolutely wonderful numbers. There are a couple of additional aspects to TR. A dose can also be reduced if your cat is in normal numbers for a week. The mid-cycle tests would tell you if Jazzy's dose should have been reduced because it looks like Jazzy could be very close to remission. With SLGS, you would have already been reducing -- you have a lot of numbers that are below 90.

As for the social norms here, it is obviously a big forum. We can't get to know everyone. Like Sue, I work during the week and my hours routinely exceed a 40 hour week. (I can't even remember when I worked 40 hours -- it's usually a lot more.) I'm sometimes able to check in during the day. By the time I get home, I'm totally exhausted from a day of Zoom and other activities. I'm guessing it's the same for many others. I've been around a whole let less since Covid since I work in healthcare and there's been a huge demand. I do try to be here during the weekends and sometimes in the early AM. Thus, the more you post, the more people get to know you. If you post in other people's threads, they will reciprocate -- and looking at other spreadsheets can be very informative as can reading a thread that seems to be related to your cat is also helpful. Like Sue suggesting, using eat "?" icon in your subject line or indicating if you have a question or problem will get attention. Experienced members and the moderators look for that information since everyone's time is limited.
Thank you so much for your input. I have given insulin
Regarding testing...
The more you test AND give a treat, the greater the likelihood that Jazzy will get used the process. Give your kitty a reward every time you test. I would even suggest taking Jazzy to the testing spot, play with his ears, and just give him a treat. The more the expectation that something good will happen with a test, the easier it gets. Also, it really depends on what your cat considers a treat. Mine was highly food motivated. There are members who would find brushing was a treat.

The reason the spot checks are so important is that Lantus dosing is based on the nadir (the lowest point in the cycle). Based on your curves, Jazzy's cycles have been pretty flat -- which is wonderful. However, you also don't want to miss a possible dose reduction.

There are differences between TR and SLGS. I'll do my best to give you a feel for how they differ. Both methods encourage getting an AMPS and PMPS and at least one additional test each cycle -- so a minimum 4 tests per day. Regardless of which approach you use, you need to have enough data to know when Lantus onset and nadir occur and how much duration your cat is getting.
  • Tight Regulation (TR) Protocol: This is a research based approach for Lantus and Levemir that was published in a leading feline veterinary journal several years ago. It's strength is that it can get a considerable percentage of newly diagnosed cats into remission. It is aggressive. Once the depot is established, doses are evaluated every 3 days if nadirs are > 200 and every 5 days if in lower numbers. When using a human meter, dose reductions for a cat within a year of diagnosis are given when numbers drop below 50. You gradually work your way down to shooting any number above 50. For someone brand new to FD, the "post and ask for help" pre-shot number is 150. Because you can be dealing with lower numbers, more testing is often necessary. FWIW, many of us who work full time are able to still use this method. You cannot use TR if your cat is eating any form of dry food.
  • Start Low Go Slow (SLGS): SLGS was developed here. It is an approach that is applicable to a broad range of insulin types, not just the depot insulins. There is no formal research that documents the utility of the approach but many cats have achieved remission using this method. There is also far greater flexibility. Dose reductions occur if numbers drop below 90. Doses are held for a week, you run a curve, and then decide if an increase is needed. One of the issues that I often see with SLGS is that people hold the doses for too long. The "post and ask for help" number for a new member is 200. Again, people seem far more reticent to start to shoot lower numbers.
It it's not evident, my personal preference is for TR. It's what I used with Gabby. I think the instructions are far better laid out. TR was first used by the Lantus group based in Germany and that's where the research data were collected. One of the members here brought the protocol to this group. I like the science behind it. However, the approach isn't for everyone.

So that's the general perspective. With Jazzy, you're seeing absolutely wonderful numbers. There are a couple of additional aspects to TR. A dose can also be reduced if your cat is in normal numbers for a week. The mid-cycle tests would tell you if Jazzy's dose should have been reduced because it looks like Jazzy could be very close to remission. With SLGS, you would have already been reducing -- you have a lot of numbers that are below 90.

As for the social norms here, it is obviously a big forum. We can't get to know everyone. Like Sue, I work during the week and my hours routinely exceed a 40 hour week. (I can't even remember when I worked 40 hours -- it's usually a lot more.) I'm sometimes able to check in during the day. By the time I get home, I'm totally exhausted from a day of Zoom and other activities. I'm guessing it's the same for many others. I've been around a whole let less since Covid since I work in healthcare and there's been a huge demand. I do try to be here during the weekends and sometimes in the early AM. Thus, the more you post, the more people get to know you. If you post in other people's threads, they will reciprocate -- and looking at other spreadsheets can be very informative as can reading a thread that seems to be related to your cat is also helpful. Like Sue suggesting, using eat "?" icon in your subject line or indicating if you have a question or problem will get attention. Experienced members and the moderators look for that information since everyone's time is limited.
Thank you so much for your reply. I have given insulin with numbers in the 70s before, but 56 was a first. With circumstances as they are today, I just didn't feel comfortable. It's been a super stressful month pet wise and I just couldn't deal with another potential emergency today. So I thought it best to avoid any danger. I think Jazzy will be ok for one cycle. I'm sure it will throw him off a little bit, but we'll get through that. But I appreciate all the help today. I know everyone's time is limited. My husband works in healthcare as well, so he's been incredibly busy too. Makes it hard to be consistent with midcycle tests. I have no idea how we're going to coordinate all this when school starts back, as I am a school bus driver/trainer. So I'll be working 10 hour days too. Lol. It's going to be interesting
 
Regarding testing...
The more you test AND give a treat, the greater the likelihood that Jazzy will get used the process. Give your kitty a reward every time you test. I would even suggest taking Jazzy to the testing spot, play with his ears, and just give him a treat. The more the expectation that something good will happen with a test, the easier it gets. Also, it really depends on what your cat considers a treat. Mine was highly food motivated. There are members who would find brushing was a treat.

The reason the spot checks are so important is that Lantus dosing is based on the nadir (the lowest point in the cycle). Based on your curves, Jazzy's cycles have been pretty flat -- which is wonderful. However, you also don't want to miss a possible dose reduction.

There are differences between TR and SLGS. I'll do my best to give you a feel for how they differ. Both methods encourage getting an AMPS and PMPS and at least one additional test each cycle -- so a minimum 4 tests per day. Regardless of which approach you use, you need to have enough data to know when Lantus onset and nadir occur and how much duration your cat is getting.
  • Tight Regulation (TR) Protocol: This is a research based approach for Lantus and Levemir that was published in a leading feline veterinary journal several years ago. It's strength is that it can get a considerable percentage of newly diagnosed cats into remission. It is aggressive. Once the depot is established, doses are evaluated every 3 days if nadirs are > 200 and every 5 days if in lower numbers. When using a human meter, dose reductions for a cat within a year of diagnosis are given when numbers drop below 50. You gradually work your way down to shooting any number above 50. For someone brand new to FD, the "post and ask for help" pre-shot number is 150. Because you can be dealing with lower numbers, more testing is often necessary. FWIW, many of us who work full time are able to still use this method. You cannot use TR if your cat is eating any form of dry food.
  • Start Low Go Slow (SLGS): SLGS was developed here. It is an approach that is applicable to a broad range of insulin types, not just the depot insulins. There is no formal research that documents the utility of the approach but many cats have achieved remission using this method. There is also far greater flexibility. Dose reductions occur if numbers drop below 90. Doses are held for a week, you run a curve, and then decide if an increase is needed. One of the issues that I often see with SLGS is that people hold the doses for too long. The "post and ask for help" number for a new member is 200. Again, people seem far more reticent to start to shoot lower numbers.
It it's not evident, my personal preference is for TR. It's what I used with Gabby. I think the instructions are far better laid out. TR was first used by the Lantus group based in Germany and that's where the research data were collected. One of the members here brought the protocol to this group. I like the science behind it. However, the approach isn't for everyone.

So that's the general perspective. With Jazzy, you're seeing absolutely wonderful numbers. There are a couple of additional aspects to TR. A dose can also be reduced if your cat is in normal numbers for a week. The mid-cycle tests would tell you if Jazzy's dose should have been reduced because it looks like Jazzy could be very close to remission. With SLGS, you would have already been reducing -- you have a lot of numbers that are below 90.

As for the social norms here, it is obviously a big forum. We can't get to know everyone. Like Sue, I work during the week and my hours routinely exceed a 40 hour week. (I can't even remember when I worked 40 hours -- it's usually a lot more.) I'm sometimes able to check in during the day. By the time I get home, I'm totally exhausted from a day of Zoom and other activities. I'm guessing it's the same for many others. I've been around a whole let less since Covid since I work in healthcare and there's been a huge demand. I do try to be here during the weekends and sometimes in the early AM. Thus, the more you post, the more people get to know you. If you post in other people's threads, they will reciprocate -- and looking at other spreadsheets can be very informative as can reading a thread that seems to be related to your cat is also helpful. Like Sue suggesting, using eat "?" icon in your subject line or indicating if you have a question or problem will get attention. Experienced members and the moderators look for that information since everyone's time is limited.
Please disregard my response where it only says that I have given insulin and ends there. My other cat bumped my hand because they are all very demanding for attention. It posted when I wasn't finished my reply. Cats.....
 
Even if you are a pro at shooting low numbers, safety always comes first. If you can't be home to monitor, don't shoot. If you're sick or exhausted, it may make sense to not shoot or to shoot a reduced dose. Everyone here understands that you can't take good care of your cat if you need to take care of yourself.
 
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