Bear's first post-need help with dosing

Status
Not open for further replies.
B

BettyL

Member Since 2013
Hi everyone- This is my first post here. It was suggested that I post here from now on to get advise on Bear's Lantus dosage. Please read my last post on the regular health forum, because I gave some information on what I did this morning. I just tested Bear at +2 and she was 70 points higher.Is that because she ate her morning meal? Is it OK to test every two hours? Those were my instructions per my vet. I really appreciate all the help.
Betty
 
Did you feed before your tested and if so, how much time transpired between feeding and your AMPS test?

(You want to test prior to feeding.)
 
I tested her first, then fed her right after the test. After she was done eating, we gave her the shot.
Betty
 
Here's the link to your last post on Health. Just as an FYI, we link our posts each day. In other words, tomorrow, you'll want to link this thread to your new thread (aka "condo") that you'll start tomorrow. We start a new condo each day for each cat (one condo per cat per day).

Perfect. Food would not influence the pre-shot number unless you provided a snack between +10 and shot time. You don't want to feed 2 hour prior to shot time. It is possible that your +2 reflects a food spike. It's also possible that you're seeing the start of a bounce. We'll have to see how the rest of the cycle plays out.

It's your decision (and Bear's, depending on what the numbers look like) whether you shoot 0.25u or 0.1u. The biggest issue is collecting the test data so you know how your dose is working. Lantus dosing is based on the lowest number in the cycle (i.e., the nadir). You don't adjust the dose based primarily on pre-shot numbers. Gathering the data today, like you indicated was your plan, will be very helpful.

Just as an FYI, if you want to be sure that Bear has food available during the day when you're not home, you may want to consider a timed feeder. Many of us who aren't home during the work week use them as a way to insure that there's food available. Alternatively, you can make "catsickles." You add water to low carb cat food so it's a bit soupy and then freeze the food in ice cube trays. You can then leave the frozen food out. It will stay fresh for hours (unless you have a cat like mine who will lick the cubes!).
 
Link to Bear's Health post: http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=89125. I will leave the dosing advice to others.

I too work M-F and often work late & sometimes have issues with the 12-hr dosing schedule. If either or both of my 2 (Tinkerbell & Tawny) are on the safe-to-shoot but low side in the mornings on a work day, & since I have a lot of data and know pretty much how a certain dose will affect each kitty, I usually go ahead and shoot their regular dose but shut them up in "their room" with plenty of food and water to get them thru the day. (I have other cats so I have to keep the food away from everybody else or it might get eaten b4 Tink or Tawny need it.) Of course this can throw off the pmps #s b/c I don't have any way of knowing how close to pmps time they have eaten & if they have eaten up to 3 hrs b4 that # may reflect a food spike. You will find whatever balance works for you and Bear once you have more data and can better tell how a dose affects Bear's #s thru out the cycle.

Yes, test every 2 hours today to get the curve, and if you can post his #s after each test. Unless Bear's #s drop to a point where you need to test more often, every 2 hrs should give you good data. If the #s do go to a point where you need to test more often or feed to bring them up, posting here will enable s/one here to advise you thru any low-# scenario.

Welcome to LL!
 
Just took Bear's +4-still above PS BG. Usually her BG drops more than this when do PM testing. For some reason we had trouble getting blood this time and it took 3 pokes, so not sure if stress played apart in the higher this time. Are AM curves different than PM curves for some reason? Also I am giving her freeze dried chicken treats when do testing.
Thanks
Betty
 
You really don't have sufficient data to call anything a curve yet. A curve is testing every 2 hours. A mini-curve is testing every 3 hours. Curves allow you to figure out when Lantus onset and nadir fall and how much duration your kitty is getting.

It's also possible that Bear is experiencing a bit of a bounce. You don't know if numbers went lower than the 154 last night.
 
just saying welcome!! i am new here myself but can tell you that this is the best place to be. the experts here are like kitty gaurdian angels o:-) , they are saints each one of them. there patient, kind and understanding. i wouldn't be were i am now with out ((((fdmb)))) hang in there, it will get easier, or so they say ;-) jk it does!!!
 
BettyL said:
What is the significance of 154?
Betty
Click to expand...
The number itself isn't significant. What Sienne was pointing out was that Bear could have gone lower than that later in the cycle, and the yellow numbers today may be evidence of a bounce off of the lower numbers.

Glad to see you got so much help yesterday and are posting here, Betty. This is the forum where you'll get the most feedback and the most experienced eyes on Lantus specific questions :-)

Carl
 
Carl-I just wanted to thank you for everything you've done to help me. I really appreciated the late night and eary morning advise especially when Bear was on N and dropping fast. I hope you still check in. You are very good at helping me understand what is actualy going on.
Thanks again!
Betty
 
Welcome to the board, Betty. :)

I just wanted to point out that there are a lot of experts on here with tons of knowledge, Sienne being one of them, and she's helped many people through countless trials and errors when people first join, and throughout their own journeys, too. I think she's also a nurse, too, although I'm not 100% certain on that (correct me if I'm wrong, Sienne).

Over time, you'll get used to everything on here, and you too will learn everything there is to learn about Bear's diabetes, ie. weight management, food amount management, dosing, etc. The people on here are all trying to help you help Bear. I've had many people give me advice over the past 3 years, and I've taken everything and learned through them. However, I also did a lot of research on my own with regards to getting Blackie to where she's at now. Everyone has done the same, and because of that, we've all gained some knowledge with regards to treating diabetes, and how the food, weight and insulin work together. You'll get there. You just need a ton of patience, that's all.
 
BettyL said:
Carl-I just wanted to thank you for everything you've done to help me. I really appreciated the late night and eary morning advise especially when Bear was on N and dropping fast. I hope you still check in. You are very good at helping me understand what is actualy going on.
Thanks again!
Betty
Click to expand...

Betty,
You can't get rid of me that easy:-)
I will certainly continue to follow along. I post here often, and occasionally pull an all-nighter when needed here. I will always defer to those with lots more Lantus experience because I never used this insulin myself. But if I can help, I will.
Carl
 
hi betty! welcome to the group! happy to see you made your way over here!

lantus is a "depot" insulin... meaning one dose builds upon the next and a single consecutive dose can affect the action of the insulin for up to the next three days. this means you won't see the "full effect" of any dose administered consecutively for a few days. liken it to medications that take time to build up in the system before the med reaches it's full effectiveness.

you can read more about the "depot" here:
STICKY: LANTUS & LEVEMIR - WHAT IS THE INSULIN DEPOT?.

today is bear's second consecutive dose of 0.25 unit. we'll have to see a total of at least six consecutive cycles at this dose to get a good idea just how well 0.25 unit is working. however, if bear were to drop too low at any time while on the dose it would be an indication the dose was too high and a dose reduction would be recommended.

in a roundabout way what i'm suggesting is this... don't attach any particular significance to the numbers you're seeing today except to learn if the dose drops him too low or leaves him with a preshot number that you're not comfortable shooting tonight.

the data you're collecting today may not seem to give you a whole lot of answers at the end of the day, but over time you'll begin to pick out patterns which will help you learn about bear's response to insulin... and we can help you with that.

post often. there are plenty of folks here day and night who are willing to help. ask any questions you may have...
 
The +2 looks like a food spike. Lantus has a 2 hour onset, meaning it'll take about 2 hours for it to start working. As you follow the protocol, Bear's #s will look better. Hang in there. :smile:
 
nice smooth day today. :smile: As Jill said, give it a couple of days for the depot to fill and we'll see what Bear can do with this dose.
 
Welcome to LL Bear and Betty! You are doing fine and asking good questions. It seems complex now, but you will learn as you go along. There are always people here to help you.

Ella & Rusty
 
Hi-just wondered what everyone thought about giving Bear her shot in the morning. I won't be home until it is time to test and give PM shot.
She lives with 9 other cats in a large one room cottage.There is a bathroom with a door. I did not feed Bear any snacks today, just treats when testing. I can lock her in the bathroom with some extra food; maybe some frozen wet as suggested. Definitely need to look into a timer feeder. Bear has always been a food addict and snarfs everything down in sight. Just wondering if everyone feels comfortable with me giving her a shot at the .25u dose? Her AM numbers are often below 200. This has always been my problem; low AMPS,not home to test, and not home to feed food as needed.

Also wondered if anyone had some thoughts on how to work with my new vet. Unlike my old vet, she believes in Lantus and some home testing. But we definately disagreed on starting dose, which meter to use, and how often to home test. As you may know if you followed some of my other posts, she wanted me to start at 2 units, believes too much testing causes stress, and does not like my Relion meter. I was suppose to do a +2,4,6 this morning and give her Bear's AMPS # from tomorrow morning using her pet meter. She agreed to a reduced dose of 1 unit, not because she thought it was warranted, but to appease me so I wouldn't worry so much. She said it would just take longer to get Bear regulated. I never gave the 1u and ended up at .25u. So I am going to tell her tomorrow I didn't do anything you asked me to do. I did it my way. I'm just worried she won't want to continue working with me. I know some of you are probably thinking I should find another vet, but she is actually the best in my area. If Bear had any serious emergency issues, I have to have somewhere to take her. I actually like this vet ,but not sure how to establish a working relationship with her. I know she is going to have a major reaction when I tell her I am giving .25 units.
Thanks
Betty
 
I never gave the 1u and ended up at .25u. So I am going to tell her tomorrow I didn't do anything you asked me to do. I did it my way. I'm just worried she won't want to continue working with me. I know some of you are probably thinking I should find another vet, but she is actually the best in my area. If Bear had any serious emergency issues, I have to have somewhere to take her. I actually like this vet ,but not sure how to establish a working relationship with her. I know she is going to have a major reaction when I tell her I am giving .25 units.
Click to expand...

Betty,
Just show her the data. When she sees what kind of numbers you've been seeing, she will realize that 1u would be excessive. She can not possibly look at your spreadsheet, and say "I was right and you were wrong" when the numbers come from a dose that is .25u and even that low, you've had to skip shots due to low numbers. She said not to shoot if under 200, didn't she?

I would hope that she would look at your data and say "holy cow, Bear is doing wonderfully on such a tiny dose! Thank goodness you didn't give 1u without a lot of testing! And two units would have been dangerous!".

I wouldn't want you to have to find another vet. I'd be hoping you can get this vet to adjust her way of thinking and take Bear as a unique case that doesn't quite fit the mold. That whole ECID concept. It's much better to be able to get your vet on board than to find a new one.

Carl
 
Betty:

I think what you can do is be honest with your vet. It's not that you are wanting to tell her you know more than she does. Your concern is that you're not home and you're worried about Bear. I think if you can communicate your apprehension that will help. Likewise, you don't have very much data from the middle of the cycle. I think if you frame your decision as choosing to keep Bear safe until you have more data and can be more confident with respect to how he responds to Lantus, that may go a long way to helping her understand your decision making. Most vets (and MDs) understand if you tell them you're scared. You can also show her that Bear is going into blue numbers on the days when you have spot checks and how you need to become more comfortable with handling lower numbers. I'd ask for her understanding and help.
 
Hi-Thanks for the advise on my vet. What is so hard is that I consider myself a reasonable open minded person, but these vets go on the defensive. I just tested Bear at +2 and was able to get the control on my vets meter to work(we were applying too much of a drop) so I compared mine with hers. Mine-204 Vets-241. Does that mean anything? Is hers actually a little more accurate and that means maybe Bear isn't doing as well as I thought?

Really would appreciate some input on tomorrows AM shot.

Thanks
Betty
 
Hi Betty. I just wanted to welcome you to LL. This is where you want to be if you have a diabetic kittie. The folks here are true cat people and go above and beyond to offer support and advice.

Have a great evening.
 
Betty,
Just a note about your meter. The vet meter will generally read about 30 points higher than a human meter like your relion. So the two readings are about equal. Most of us use some kind of human meter, generally one that has cheap test strips, cause we end up testing a lot. Just let the vet know which meter the reading is from and that there is a 30 point difference.

Bear's numbers are looking good for just a couple of days on insulin. You are on the right track.

John
 
In the beginning, my vet and I butted heads, also. My vet didn't believe that Lantus worked on cats, until she called me up one day to inquire about it for a new patient of hers. I gave her the information, and she treated that patient. I had to make a visit there one day for an unrelated case, and I asked her how the patient was doing. She told me that she was able to get the cat regulated on 2u BID. The next sentence from her was, "That stuff works!" Now, she knows. She also knows that diet plays a huge part in controlling BG #s, too.

Be honest with your new vet as Sienne said. You have Bear's life in your hands. The more information that you can provide for your vet, the better the vet can help you treat Bear, and together you both can help get her better.
 
Status
Not open for further replies.
Back
Top