9/29/11 MILO PMPS 115 Dose advise

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milo

Member Since 2011
Just want to make sure I was reading the sticky correctly....anything under 150 dont shoot?? This is the lowest I have seen milo since diagnosed, I think the diet changes has helped alot.... any advise??? Last time I didnt shoot he was 198 and the next morning it went up....
 
Are you able to stall -- without feeding -- and monitor tonight?

Did you really shoot blind this morning or did you forget to enter the AMPS test? From what you're seeing tonight, if you are shooting blind and not getting any spot checks, this is a dangerous practice.
 
He just ate very little now, and he didnt get checked this AM because I was running late.... so thats somthing I try never to do....
 
Yes I am able to stal, from what I read on what u posted I need to get a reading at +10 & +11 to see where the numbers are, will I have to change his shot time in the AM?? Im not sure if Im clearly understanding what I'm reading.. sorry...all this really confuses me, even when I read and re-read the stickys..I s=dont know if I will ever "get" all this!
 
IMHO, until you are able to get every preshot reading and at least 1 spot check per day, you're not ready to aim for tight regulation. Is tight regulation something you are looking for, or are you looking for more loose regulation?

Using the Tight Regulation Protocol we do shoot low, but it requires a fair amount of monitoring. It's ok if that's not what you want, but then you wouldn't want to shoot very low. 150 or 180 is usually a good guideline then.
 
I do not know what IMHO means, (sorry) but I would like to have a tight regualtion, so I was testing several times a day to see what his numbers were doing and my vet told me I was testing too much, and probly driving him crazy etc.. and said it wast needed... so I gave him a bit of a break one day and didnt have time this AM, I just took his blood again now +1 107, so its gone lower and I havent fed him, but I have no idea what that means (his numbers lowering) like I said for some readon all this is not "clicking" with me and I am having a hard time as to what to do...I dont want to not shoot him, he bounces back up and we just do this over and over and he never gets regualted because of my fear, so I'm not sure what now to do,,,,Im really frustrated
 
IMHO = In My Humble Opinion

Many vets have discourage home testing. They seem to think we're torturing our cats. It's not the case. Ignore your vet. Milo is your cat and you will do what you need to do to keep him safe.

If you want to follow tight regulation, it is vital to test at every shot time and to get spot checks (the minimum is one) each cycle (i.e., every shot starts one cycle -- there are 2 cycles per day).

Tight Regulation sticky said:
WHEN FOLLOWING A TIGHT REGULATION PROTOCOL WITH LANTUS OR LEVEMIR:

Kitty should be monitored closely the first three days when starting Lantus or Levemir.
Blood glucose levels should at least be checked at pre-shot, +3, +6, and +9.
More monitoring may be needed.

It will be necessary to test kitty's blood glucose levels multiple times per day.

Learn the signs of and how to treat HYPOGLYCEMIA and prepare a HYPO TOOLBOX.

Test regularly for ketones and know about DIABETIC KETOACIDOSIS (DKA).

Use U-100 3/10cc syringes with half units marked on the barrel for fine dosing.

Feed a high quality low carb canned or raw food diet.

Feed small meals throughout the day. Some kitties adapt well to free feeding.

Right now, you do not have the data to shoot this low of a number. We may need to look at adjusting Milo's dose to a smaller amount so you can shoot twice a day. This is something that often happens with some cats. They get on a low carb diet and start Lantus and we need to adjust dose due to skipped shots. I wouldn't worry about it.

I would suggest that you get some tests in this evening. It will be important to know when Milo's numbers start to rise.
 
IMHO = In My Humble Opinion

Your choices at this point are to either skip the shot, shoot a token dose, or stall (without feeding) and wait until he rises to a number you are comfortable shooting. I'm a little concerned about the way you reached your dose, so I'm not comfortable telling you what number I think is ok to shoot. It looks like you were shooting 2.5u AM and 3u PM until yesterday, and then increased last night to 3.5u, is that right? We don't recommend doing dose increases without nadir tests because without them, it's impossible to tell how low the dose is taking the cat.

My suggestion would be to skip tonight's shot, then start over in the morning and shoot the same dose in both AM and PM cycles. I would probably go with 2.5 units both cycles, get serious about testing, and then start following the protocol for dose changes. Most cats get better numbers when they are changed to a consistent dose, so it would be safer to start a little low and then work up from there. You can already see that 3.5 units twice a day is a little too much for where you are right now. You might get back to that dose, but it's better to work up to it systematically so you'll know it's ok. Make sense?
 
Yes, That makes sense to me, thanks.... I agree about the testing, when my vet said that it made me feel bad,but now that I think of it, why wouldn't I test him? I mean if I would have shot him tonight without the test lord knows what would have happened! So I will start again tomorrow, on the lower dose and test more as well, thanks again for everyones help....I really needed it!
 
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