? Do I dose? AMPS 385, PMPS 185

Gingembre1

Gingembre1

Member Since 2018
Lantus, currently at 5 units/dose

Edited to add: I just tested him 30 min later and his numbers have dropped to 175

This is the first time he’s ever been this low, I don’t know if I should give him 5 units, or take him down to 4? Or??

He’s due for his insulin right now, hence the urgency. I’m scared to dose him without some advice.

And yes, I know I stepped him up very quickly, but given his high numbers, and how he’d been reacting (not reacting) to insulin, and I was home all day, I felt comfortable doing so.

Thank you!!
 
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I am NOT an experienced advisor, but having been in your situation, I will tell you that he has not earned a reduction. I don't see whether you're using SLGS or TR methods, but both require a much lower number to reduce.

I would say shoot. But stay close, monitor him again - get readings at +2 and +3, then again when he hits nadir. Be ready, if necessary, to feed him.
 
Hroswitha said:
I am NOT an experienced advisor, but having been in your situation, I will tell you that he has not earned a reduction. I don't see whether you're using SLGS or TR methods, but both require a much lower number to reduce.

I would say shoot. But stay close, monitor him again - get readings at +2 and +3, then again when he hits nadir. Be ready, if necessary, to feed him.
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Thank you, I’ve been re-reading the protocols as well. I’m fast tracking him at the moment, because he hadn’t been getting any traction with the Lantus. Yesterday he shot up’to the 600s, and tofaybare the lowest numbers I’ve seen for him since diagnosis.

I’m just scared to shoot 5 units, given the drop he had today. But I’m here all evening, and can keep testing.
 
Ginger, just seeing this and that you did shoot 4.5 at the regular PM time. How is he doing? I have been searching for some Lantus people to get you a response and take a look here.
 
Idjit's mom said:
Ginger, just seeing this and that you did shoot 4.5 at the regular PM time. How is he doing? I have been searching for some Lantus people to get you a response and take a look here.
Click to expand...

Thank you! Yes, I went for it. He seems fine so far, but I’m keeping an eye on him, and making food available to him.

I’ll update here if anything changes, but definitely appreciate any insight anyone has! He’s been stubbornly stuck above 400 for so long!
 
Ok, I'm no expert, but I'm going to stick around just in case you need some support. You just never know what these cats are going to do from one moment to the next! :):cat:
 
Ok, Ginger, I am sorry none of the wise women/men were able to help this time. I have been checking the spreadsheet and don't see any updates so I hope kitty is doing well. You have been offline for almost an hour now, so I'm hoping everything is ok and you have a restful night.
 
Ginger, if you haven't already, please test and post the number.

When shooting low for the first time you want to get a test at +1 and +2 to start. Then go from there depending on his numbers.
 
Hi all, quick update, have been trying to get a test on him for the past few hours, but his ears have been super sensitive. Finally got one at +3, and he’s bounced up to 266.
 
266 @ +3
That's good, but you're not out of the woods yet. Please continue monitoring tonight. If I were in your shoes I would get another test at +5 (since you're having trouble testing) to see if he continues to rise.

Ginger, I'll leave the 911 on your thread for several reasons (for the time being):
  • you may have shot as a bounce was breaking (not enough data to tell for sure)
  • the dosing strategy is rather aggressive (you basically took him from 3.5u to 5u in a day and a half)
  • there weren't enough mid-cycle tests to support increasing the dose when he was back at 3.5u (which *may* have put him over dose... hard to tell at this point, but it's better to be prepared by monitoring carefully)
Please monitor carefully til we know how the cycle will play out.

Tomorrow's AM shot:
Please post for dosing help prior to giving any insulin. If there isn't any experienced dosing help available, please dose conservatively until we can get this all sorted out.

I'm tagging @Wendy&Neko to call her attention to his spreadsheet. I'd like her to take a look and offer an opinion.
 
Ginger, I've just been reading a little history here...

Last thread: http://www.felinediabetes.com/FDMB/threads/pmps-426-3-544-amps-558.207913/#post-2303996
  • Have you been testing for ketones?
  • I see fast tracking was mentioned... holding a dose for 4 cycles prior to increasing. However, that presumes you know how low the dose is taking him before you increase:
    • Wendy&Neko said:
      If you can monitor closely, which means a test every preshot plus one other each cycle, we can fast track you up to a better dose.
      I see a couple preshot tests missing on the spreadsheet. We strongly recommend getting a test every preshot to make sure it’s safe to give insulin. The test somewhere in the middle of the cycle gives us an idea how low he is going on that dose. We determine how to change doses based on those low points.
      Click to expand...
I'm glad you're available to test tonight.
 
353 @ +5

Looks like it's safe to get some sleep since numbers continue to rise. They do make me wonder if he's simply bouncing since it's now apparent they were on their way up at PMPS this evening.

Hope you'll be able to collect more data this weekend.

I have to call it a night. I took an allergy pill right before I was messaged to clean up some spam on the board tonight. My eyes have been tearing so badly from trying to stay awake.

Hope Wendy has time to weigh in before shot time tomorrow... oh, and I'll remove the 911 from your first post.


Goodnight.
 
In my previous post, I said that fast tracking (which wasn’t my suggestion for you) means increasing every four cycles where we have four cycles of more than just preshot data. And we only fast track if all the numbers you are seeing are above 300. At that time you said you could not monitor enough for fast tracking. Now that you have seen yellow and even blue (yahoo!), no more fast tracking. As is, you were increasing too quickly and by too large amounts for fast tracking, which is already an aggressive method. Now it’s time to slow down, employ patience and see if we can figure out what Ballsnacks is doing with the insulin dose, now that we know he can respond to Lantus.

I think your dose tomorrow would depend on how much you can monitor. If all you can get the next few days are just preshot tests, then I would go back to 4.0 units. If you can get both preshot tests, and at least one but preferably two additional tests per day, then try 4.5 units. You have previously mentioned long work days, but that makes those night time tests even more important.
 
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