Black kitty/Brandi 4/12 Can we sliding scale for Lantus? Skipping shots for <200

[Brandi Young]

I’ve skipped a few shots for my cat last week or so for numbers <200. He then rises a bit and is high enough for shot next dose. Should I be skipping those doses or giving less and still shooting? I don’t always have the time to wait and watch. If I give less, how much less?

brandi
https://docs.google.com/spreadsheets/d/1_UYRgTviAkEmGkjt5GMeA_07DhRPOBKCPkAFnaUA1AY

 

[Brandi Young]

I’ve skipped a few shots for my cat last week or so for numbers <200. He then rises a bit and is high enough for shot next dose. Should I be skipping those doses or giving less and still shooting? I don’t always have the time to wait and watch. If I give less, how much less?

brandi
https://docs.google.com/spreadsheets/d/1_UYRgTviAkEmGkjt5GMeA_07DhRPOBKCPkAFnaUA1AY

He was 290 today mid cycle even though he didn’t get a shot this morning. The 290 yesterday midday was a mistake entry

 

[Chris & China (GA)]

The hard truth is that you're going to need to start shooting those lower numbers. We say "no shot" under 200 for people who are brand new but even then, we don't really mean "no shot" most of the time.

It's more of a "stall point"....at first, if you get a number under 200, you should stall, don't feed and test again in 20-30 minutes to see if the number goes up without the influence of food. That's usually a pretty good sign that the last shot is wearing off and it's OK to go ahead and shoot.

But once you've got a little experience, that "stall point" drops to 150, so anything over 150, you'd give the scheduled dose. If under 150, you'd stall, don't feed and retest in 20-30 minutes.

Eventually, you learn to shoot lower and lower numbers. On SLGS, you work your way to shooting anything over 90.

Of course the days you do this for the first time should be days when you can keep a closer eye on him and get at least 1 mid-cycle test in.

Lantus doesn't work as well on a sliding scale as some other insulins, but it has been done.

 

[Sue and Luci]

I agree with Chris...you really need to focus on the mid-cycle numbers rather than the AM/PM pre-shot values - unless of course you get a really low reading - like 40ish...then you'd hold the food, post for help.

Any number in the blue zones are safe to shoot - eventually you'll be shooting green numbers as Black Kitty improves...Please take a look around at some of the other folks' spreadsheets - many shoot green every day.

 

[Brandi Young]

The hard truth is that you're going to need to start shooting those lower numbers. We say "no shot" under 200 for people who are brand new but even then, we don't really mean "no shot" most of the time.

It's more of a "stall point"....at first, if you get a number under 200, you should stall, don't feed and test again in 20-30 minutes to see if the number goes up without the influence of food. That's usually a pretty good sign that the last shot is wearing off and it's OK to go ahead and shoot.

But once you've got a little experience, that "stall point" drops to 150, so anything over 150, you'd give the scheduled dose. If under 150, you'd stall, don't feed and retest in 20-30 minutes.

Eventually, you learn to shoot lower and lower numbers. On SLGS, you work your way to shooting anything over 90.

Of course the days you do this for the first time should be days when you can keep a closer eye on him and get at least 1 mid-cycle test in.

Lantus doesn't work as well on a sliding scale as some other insulins, but it has been done.

You’re right, I know the hard truth but I’m scared!
I was hoping you all would say give less insulin to make me feel better about shooting under 200.

 

[Brandi Young]

I agree with Chris...you really need to focus on the mid-cycle numbers rather than the AM/PM pre-shot values - unless of course you get a really low reading - like 40ish...then you'd hold the food, post for help.

Any number in the blue zones are safe to shoot - eventually you'll be shooting green numbers as Black Kitty improves...Please take a look around at some of the other folks' spreadsheets - many shoot green every day.

Do you guys think I should go full dose 3.5 when between 150-200? I normally shoot while in 200s anyway I guess the mid to high 100s aren’t all that low.

 

[Chris & China (GA)]

o you guys think I should go full dose 3.5 when between 150-200?

Yes, until he shows you it's too much (or too little)….If he drops below 90, he'd earn a reduction in dose on SLGS. You don't specifically say in your signature which dosing method you're using, but if there's still some dry in the picture, it limits you to SLGS.

For now, hold the 3.5U dose unless he drops below 90....if his PS is under 150, stall, don't feed and test again in 20-30 minutes (and use that time to post with a good strong subject line like "STALLING, NEED HELP!!" to grab somebody's attention.

We have a tradition here that if someone encourages you to shoot a lower PS than you're comfortable with, they'll stay online as long as necessary to help watch to see how you and he are doing. If they can't stay online, they'll tell you up front so you can make a fully informed decision.

 

[Brandi Young]

Yes, until he shows you it's too much (or too little)….If he drops below 90, he'd earn a reduction in dose on SLGS. You don't specifically say in your signature which dosing method you're using, but if there's still some dry in the picture, it limits you to SLGS.

For now, hold the 3.5U dose unless he drops below 90....if his PS is under 150, stall, don't feed and test again in 20-30 minutes (and use that time to post with a good strong subject line like "STALLING, NEED HELP!!" to grab somebody's attention.

We have a tradition here that if someone encourages you to shoot a lower PS than you're comfortable with, they'll stay online as long as necessary to help watch to see how you and he are doing. If they can't stay online, they'll tell you up front so you can make a fully informed decision.

Thank you so much!