BJ's Rough Start

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do you have high carb canned food?

you want to use this rather than dry. if you don't have high carb canned is there someone who can go to the store and pick up several cans? the best to buy is fancy feast gravy lovers - its perfect for this situation.

and has it been 30 minutes - can you get another test in.
 
Mike

Dry food doesn't work for low numbers. It takes forever to get the numbers to come up with dry food and then it stays around in the system like a bad hangover.

Please take just a second to read through the posts. You have alot of experienced people asking you to give him HC gravy. We know this works :-D :-D :-D

Just breathe. We've all been at these numbers with our cats. You have alot of eyes here.
 
Okay, good. But you still want to test to make sure he doesn't drop again. Hold off on feeding more for now.
Carl
 
Marjorie and Gracie said:
Mike

Dry food doesn't work for low numbers. It takes forever to get the numbers to come up with dry food and then it stays around in the system like a bad hangover.

Please take just a second to read through the posts. You have alot of experienced people asking you to give him HC gravy. We know this works :-D :-D :-D

Just breathe. We've all been at these numbers with our cats. You have alot of eyes here.
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I'm on panic attack mode, I'm sorry guys. Besides the dry food all I have for gravy is from his old Friskies. I will use that next time unless not advised.
 
MIke,
Nothing to be sorry for. We understand "panic attack mode". It's one of the reasons people hop in to try to help. Low numbers, at first, freak you out. They freak out the kitty too in some cases. But, you and BJ will get used to them, and you'll know exactly what to do.

The Friskees gravy food would be fine too. If it's got gravy, it's most likely high carb. The trick is giving the most carbs in the smallest portion size, which is why we suggest gravy as a first step. It raises BG pretty quick, but it also goes away quick, and it takes up very little room in the stomach. The dry just takes a longer time to digest and then hangs around longer.
You're doing great!

Carl
 
ok one more test in 30 minutes to be sure he doesn't drop again.

please read through the posts and recommended links tonights/tomorrow.

but you did well and glad that +4 reading.

now when you do the next shot - drop the dose as he earned it - what i'm not sure is whether you should drop to 1 unit or 3/4th unit -

and tomorrow you may want to post your amps on the lantus board BEFORE shooting just to be sure what dose to use

make sense?
 
Agree with Hillary.

Tomorrow, test and post before dosing, and at most, it would be 1u. Best place to post is on TR for dose questions that need a quick answer.

Do not be surprised by high numbers in the morning. He'll most likely "bounce" from today's lows, and it may take a day or longer for that to clear out of his system.

Great job, Mike (and BJ)

Carl
 
To be clear, he gets his shots at NOON and MIDNIGHT.

Should I NOT give him anything for his MIDNIGHT dose?

Going to warm the ear sock now, bbiab.
 
before we advise whether to dose or not, where are you? how many hours until midnight for you - I'm on east coast so it's almost 11 pm for me.

this will help, also can you get another test in now, so we know where he is at.

and it maybe ok to dose but definitely a reduced dose no more than 1 unit and maybe less. lets get some more opinions and will you be up to test? or could you wake up and test? just to be sure you don't have another huge drop.
 
7:49pm Pacific.

So, he twisted his head while lancing him and tore him up a bit and got a huge drop (of blood) and crazy readings.

BG (253), (433), (379). This is three times from the same blood drop, one after another.
 
Mike, you are getting great advice. Great job!! Low numbers are freaky and you handled everything very well. The good news is BJ is responding to Lantus. :-D
Liz
 
Anne & Zener said:
Mike, you are getting great advice. Great job!! Low numbers are freaky and you handled everything very well. The good news is BJ is responding to Lantus. :-D
Liz
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I sure hope so! Yeah, the bad news is I'm screwing everything up *sigh*. I felt a lot better seeing the BG100 and 151 but the new numbers are nuts.

If I only started him at 1u like I was instructed, we would be better off now. At least I lowered to 1.5u instead of the 2u the vet wanted me to do!
 
OK, Mike, you can probably go with the first number you got. But, all 3 are probably suspect if there was a large amount of blood because sometimes you can get a messed up reading if the sample is too large. That happened a few times with me when I would hit the vein directly and it was a bloodbath.

Given that his numbers have been climbing and continued to climb past what the food should have done to boost them, you're possibly looking at "bounce" numbers going into tonight's shot. Yes, I think you'll be able to dose him at midnight. And I'll probably still be awake (3am here) as will others, so you'll be able to get help if needed before shot time.

I'd give his ears a break until 1130 or so your time, then just post the number and we can go from there. Sound good?

Carl
 
If I only started him at 1u like I was instructed, we would be better off now. At least I lowered to 1.5u instead of the 2u the vet wanted me to do!
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You did right by cutting back from the 2u the vet wanted you to do. The 1u vs. 1.5u question? Forget it, buddy. Put it in the rearview. After today, it's a whole new world going forward. Don't worry about "woulda coulda shoulda".

Carl
 
Maybe those new crazy high numbers are the result of the dry food you gave and will wear off over time. The experienced members will advise if they think this is the case. You did great tonight. It is not always this hectic. The key is starting low and going slow. :) If things get too crazy and you are ever unsure of what to do, just step back and ask for help. :)
 
Okay. I am going to take a break. Bj seems okay and is napping (he is pissed I interrupted nap time 5 times) so I am going to get off the puter for a bit and try to unwind a couple hours. I'll get his BG again before midnight and see if anybody thinks I should skip his next dose or not.

Hillary & Maui said:
before we advise whether to dose or not, where are you? how many hours until midnight for you - I'm on east coast so it's almost 11 pm for me.

and it maybe ok to dose but definitely a reduced dose no more than 1 unit and maybe less. lets get some more opinions and will you be up to test? or could you wake up and test? just to be sure you don't have another huge drop.
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I'm west coast (pacific). I suppose I could stay up til 3am and check then. Well, whatever is advised - I'll do whatever I have to do. I'm pretty terrified of having him drop in the wee hours though. Late at night is not a great time if I have some emergency.

Sorry I'm late and if I missed any other replies I apologise.

Thank you all SO MUCH.
 
Hi again, Mike,

I wanted to get this out there so you would see it before shot time. After thinking about it, and discussing it with a couple of other people who are much more familiar with Lantus that I am, here's what I'm thinking...
The Tight Regulation protocol, if that is what you're trying to follow, would indicate a reduction of .25u, so tonight it would call for a dose of 1.25
One important thing to keep in mind no matter what you shoot is how Lantus works. It is called a "depot" type insulin and it has a cumulative nature, where each dose builds upon the previous dose and forms what we refer to as the "shed". Because of that, when you reduce the dose, the depot is still there, so you might not see the results of a reduction immediately. It might take a day or longer for BJ to adjust to the lower dose. I guess what I'm trying to say is that even if you shoot less tonight, you could see the same thing you saw today happen again tonight. What that means is that you need to be prepared for that, so if it does happen, you see it coming early.

To some extent whether or not or how much you can monitor his numbers overnight will play a part in how much you want to shoot. But no matter how much you give tonight, you should monitor. That doesn't mean you need to stay up all night. If you test him at +2 and +3, if he's going to drop quick or far, you should be able to tell by 3 hours after the shot. Do you have gravy/higher carb canned food, test strips, and can you stay up or set an alarm to check his BG a few times in the first 2-3 hours of the cycle?

You can shoot 1u if you choose to. Actually, keep in mind that it is always your decision because as we always say "you hold the needle". We advise, you decide, to paraphrase Fox News! It all comes down to your level of comfort when it comes to dosing. You can shoot 1.25, 1u, .75, .5 or even skip the shot (although I wouldn't recommend skipping on any number over 200).

If you test him about half an hour before midnight, and then again at midnight, you'll have a better idea what to do. If his number is rising, it would be okay to give him some insulin, but you will need to get spot checks overnight. Maybe at +2 and +3. If you don't see a big drop by then, maybe set the alarm for +6?

If you decide to skip the shot altogether tonight, you can do that. Without more insulin, and assuming his numbers are up in the 200-300 range at shot time, he won't drop low overnight.

Tomorrow, it might be a good idea to start posting in the Lantus Tight Regulation forum. Most of the people who have been helping out today spend most of their time there. Lots of other people there can also give you great advice. It's the busiest forum on the board, and somebody is usually there 24/7. It's the best place to post if you need a quick reply.

Carl
 
I think Carl has done a good summary.

The take home is you need to get a PS and see where he is. If he's over 150 and rising quickly, I'd shoot 1.25u and get a +2. If his +2 is much higher than PS, you should be ok to go to bed. If its the same SS or similar, you can expect a typcial cycle. If the +2 is much lower than PS, you can expect an active cycle.

I also want to add that if you can't start getting some nighttime tests, Mike, I'd take his dose down more.m you are missing half of his data by not getting a +2 and before bed test.
 
Wow, I was expecting a bounce, but not that high. If you test in 30, you'll know whether that was accurate, or (hopefully) a bad test strip?

Carl
 
Hi Mike, I was just alerted that you may need some eyes, so I thought I'd stop in. Trying to catch up on your thread and SS, back in a few, k?
Jane
P.S. Your SS begins on PM cycles (on the left), is that intentional? Still trying to work out where you are, timezone-wise! :smile: No BGs listed in AM cycles?
 
OK then...

Did you read what I posted an hour or so back about tonight's dose? And what Marje said? What do you think?

Carl

Edit- Hi Jane! Nice to see you. :-D
 
Carl & Bob in SC said:
OK then... Did you read what I posted an hour or so back about tonight's dose? And what Marje said? What do you think? Carl Edit- Hi Jane! Nice to see you. :-D
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Hi Carl. I'd say go with a 1.25, I think Marje suggested thatalso, earlier? Still playing catch up! Carl, thoughts on 1.25u?

Mike, are you comfortable shooting 1.25u? Got strips? Food? HC? BOS? :mrgreen:
Jane
 
I think the 1.25 is good, provided Mike can get a test by +3 just in case BJ decides to drop early and fast.

Carl
 
Carl: Yes, I did. I just fed him and have a syringe loaded with 1.24u. Doing last minute thinking before shot.

I have supplies.

Jane: It's confusing because the first shot of the day is at 12 NOON. I might start at 11AM but not now.

I haven't been getting enough readings til now, unfortunately.
 
Mike and Bj said:
Carl: Yes, I did. I just fed him and have a syringe loaded with 1.24u. Doing last minute thinking before shot. I have supplies. Jane: It's confusing because the first shot of the day is at 12 NOON. I might start at 11AM but not now. I haven't been getting enough readings til now, unfortunately.
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No worries, Mike. You're getting tests from now on, so we'll soon have good data to be able to advise you even better. I'd say go ahead and shoot and strap on those BOS.
What's your local time at exactly shot-time, please?
Jane
 
12AM Pacific Time.

Disaster. He has been freaking out the last few shots and this time he jerked and I wasn't able to get it in him. I read NOT to give him any more. I'm pretty confident that little to none went in. What to do now?
 
Mike, you shoot what you think is best. It's just one dose, one 12 hour segment in the big picture. Marje said it well in another thread tonight to someone not quite sure what to shoot on a low number:

if he's going to go low this cycle, he will do it whether you shoot a full dose or a BCS. If he's going to bounce, he will do it regardless of what you shoot. It can take up to six cycles to drain the depot....you could have low numbers tonight whether you shoot full dose or BCS.
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The depot that has been built up so far is going to determine what happens tonight more than the dose you give him right now.

Carl
 
Oh poop.

OK, so maybe part of it went in? But some missed?
Carl
 
Mike, no worries. Fur shots happen even with people who have been doing this for years. This is actually an okay thing. It makes it less likely you'll have a long night.
Carl
 
Freaking nightmare. He's escaped out the cat door and fled the country for at least a half hour.

He's gotten wise to shot time. Very wise. I'm going to have to have mom hold him for me. It's reverse of what it was, he used to take the shot well and hate the ear pricks. ohmygod_smile

Let it ride til his next shot time? Or...
 
Mike and Bj said:
Freaking nightmare. He's escaped out the cat door and fled the country for at least a half hour. He's gotten wise to shot time. Very wise. I'm going to have to have mom hold him for me. It's reverse of what it was, he used to take the shot well and hate the ear pricks. ohmygod_smile Let it ride til his next shot time? Or...
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Breathe, Mike. This happens. Again: Did you smell his fur and check for wetness? (To see if it really was a furshot.)
 
Yes, you definitely let it ride, and never shoot again if you miss the first time. If it was a furshot, that's all you can do because you have no way of knowing how much, if any, made it in. You can't risk shooting more based on a "maybe".

Carl
 
That okay too, Mike. Now we put it in the rearview and look ahead.

Can you test at +2 and/or +3, even if you need to set the alarm to do it?

If any of the insulin made it under the fur, you might see some movement down by then. If you don't see a drop by then, then you can probably get some uninterrupted sleep afterwards because he most likely won't drop to the greens you saw today.

Carl
 
Ok. Can't be helped. Many of us have given furshots - try not to dwell on it, alright?
Carl is right: Never do follow-up insulin shots. There's no way of being certain here what went in, if any

Are you ok testing a follow-up BG, at (+2)/(+3)?
Jane

ETA Carl we're cross-posting again :-D
 
Carl & Bob in SC said:
Yes, you definitely let it ride, and never shoot again if you miss the first time. If it was a furshot, that's all you can do because you have no way of knowing how much, if any, made it in. You can't risk shooting more based on a "maybe".

Carl
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Alright then. I'll resume insulin tomorrow. So frustrated right now, grrr...

My focus is just shot, there was family uproar going on the last two days and dealing with The J-Man I am brain dead. It's making me sloppy, obviously.

Anyway, I'll test him again at +2 / +3 as advised.
 
Mike and Bj said:
Carl & Bob in SC said:
Yes, you definitely let it ride, and never shoot again if you miss the first time. If it was a furshot, that's all you can do because you have no way of knowing how much, if any, made it in. You can't risk shooting more based on a "maybe".Carl
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Alright then. I'll resume insulin tomorrow. So frustrated right now, grrr... My focus is just shot, there was family uproar going on the last two days and dealing with The J-Man I am brain dead. It's making me sloppy, obviously.Anyway, I'll test him again at +2 / +3 as advised.
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Don't be so hard on yourself, Mike! You are doing fine. Thinsg will keep getting easier, I promise. Get some rest. I'll be around for your update, though Carl will problee be sleepus. You won't be alone. Keep breathing!

Jane
 
Awesome!

I'm turning in for the night (almost 4am here) but Jane will be around until the rest of the coffee club shows up in a couple of hours. You did great today Mike. Don't get too frustrated. I found it helped me to take life in 12 hour chunks when Bob was on the juice. You and he will be fine, and this gets a lot easier the more you do it.

Carl
 
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