8/3 Joplin AMPS: 235, +10: 109

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Cherylockholmes

Member Since 2013
Hello! As you can see by my spreadsheet, I've been playing a little with the units I've been giving Joplin because I'm afraid of him becoming hypo, but I don't know if that's what I should be doing. This morning, I gave him 4 units which brought him to 62 nadir at +5. He's climbing now, 2 hours before the PMPS is at 109. If I test him in 2 hours and he's still in the low 100's to 120's, is it okay to give him another 4 units tonight or should I lower it?

Thanks!
 
Hello Cheryl! I'm not familiar with what you've done up to now, but I looked over your spreadsheet and the only thing I can see is that you've switched doses 6 times over the last 8 cycles. Lantus is a depot insulin, and it's important to hold the same dose for 6-10 cycles unless Joplin "earns" a reduction, and usually increases and decreases are only .25 unit. (Although I can see you've been in reds/pinks a lot so you might have been told to do increases in .5u increments by another member with more experience)

The PS numbers aren't the most important numbers...it's the nadir (where the Lantus is it's MOST effective in each cycle) and it looks like you were into some nice greens during this last cycle!!

I'd like to see some more experienced eyes take a look, but until then, you're on a pretty high dose now, and I'd suggest since he did go fairly low earlier today, you might want to make sure to get a +2 or +3 and see where he might be headed overnight. Most cats do drop lower at night, and I'm concerned about Joplin getting too low. If his +2 or +3 is about the same as his PS numbers, the cycle should be a quiet one, but if you see a big drop or big increase, it's a more active one (and of course a big drop would mean you'd want to get more tests overnight to make sure he didn't go under 50)

I'd stick to the 3 units you shot tonight (unless he goes too low or someone with more experience advises you differently) and hold that same dose for at least 3 days (6 cycles). We want to keep him safe, as well as giving his pancreas the best chance at healing!

Also, if you add the ? icon to your subject line in your first post (it won't show up otherwise) and add something like "Dose Advice Please", it might help to get some of the other members to weigh in with their ideas.

Good luck to you both!
 
Sorry, the constantly changing doses do not work well with Lantus insulin because of the insulin depot that Lantus has.

You need to pick a dose and stick with it for a minimum of 6 cycles, possible 8-10 cycles, UNLESS Joplin drops under 50, then you get an automatic dose reduction as long as the previous dose reduction was not too recent.

With the constantly changing doses you are giving, the depot is constantly draining and refilling and we are not seeing enough time on one dose to see if this is a good dose or not.

You need to be patient and wait out those bounces into higher numbers.

I can't tell if the 3U, 3.5U, or 4U dose was a good one because none of them were held long enough. The dose you give today, might not show you any results until tomorrow or even for a couple of days.

You have also been changing the dose in 0.5U increments. With the nadirs you are getting, the protocol says to change in 0.25U increments.

Hope that helps you understand a bit better. If not, ask again until you do understand. Different people say the same information differently and one person's explanation may make more sense to you.

ETA: Yes, please get that +2 tonight to see what direction Joplin may be headed.
 
At +2 he was 138 and now +5 hes 178. I was advised by someone here to increase the dose every 3 days when he wasn't responding. I'm on my phone with limited capability so I can't link to the specific post here but that's why I did that.
 
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