Doodles AMPS 405 PMPS 357 dosing advice plz

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Wendy&Neko said:
Hi Tina - you gave tonight's dose at 7:30 PM. What time did he get his AM dose?

Because Lantus is a depot insulin, and he's been getting 3 then 4 units up until yesterday, the depot is still much larger than the 2 units you gave today. I would still go to 1 unit tomorrow morning to help drain the depot, then get some more 1/2 unit marked syringes and go back to 1.75 units.
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I gave 2u at 730am...exactly 12 hrs before this evenings dose.
 
So do I do 1u or 1.5u? I can gauge 1/2 way between whole markings.

I will test again in 20 min & if it stops dropping I can stop the test/feed/test cycle this evening?
 
Tina & Doodles said:
Geesh...how often should I feed him? Right now it is twice a day. Is that part of the issue?
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Every cat is different again. I feed my Doodles every 4 hours. You can free feed too but will need to pick up his food 2 hours before shot test time so the BG is not influenced. Many people use autofeeders. Feeding small, frequent meals is better for their pancreas too!
 
Tina & Doodles said:
So do I do 1u or 1.5u? I can gauge 1/2 way between whole markings.

I will test again in 20 min & if it stops dropping I can stop the test/feed/test cycle this evening?
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Personally, I'd just go with the 1 unit in the morning if he's over 150. If not don't shoot. This will change over the next few days once you get the 1/2 unit markings and your spreadsheet set up.

Lets see what the next test is. You'll want to get a rising number without food for 2 hours.
 
I think 1 unit is a good idea for the morning. Sorry I confused you. :facepalm: The more I think about it, the more I like the idea of getting the depot drained so we have a true picture of what the dose is doing.

Regarding the test/feed cycle, you want to have two rising test without the influence of food before you stop testing for the night. Since you don't know if he's done dropping, you need to keep testing for now. You stop giving food after the first test you get that's higher than the previous ones (provided it's over 50).
 
Doodles & Karen said:
Sorry to be a nag but did you get another test in?
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Shot 7:30 2u Lantus
+1.5 172
+3 74
+4 69
+4.5 93

On the way up...

Will do 1.5u in morning.

To be clear, I test 2 hrs before meal & then again at am meal/insulin inj, then again throughout day to see how the 1.5u is affecting him
 
Okay, you can stop feeding now. Did you feed when you tested him just now? If not, wait 30 minutes and test again.
If he's still at that number or higher, you only need one more test like that and you can call it quits. If you did feed, stop feeding and you'll need two more tests.

You do not need to test 2 hours before the meal, unless you want to. Just don't feed two hours before the shot, test at shot time, then if the number is above 150, feed and shoot. He doesn't have to eat his whole meal before you shoot. You just have to be sure he will eat. We used to shoot Cinco while he was eating, and he never missed a beat.

To clarify: AMPS and PMPS mean Morning PreShot and Evening PreShot - these are the numbers you get immediately before you shoot. Everything after that for the next 12 hours is based on the time you gave the shot - +1 is one hour after the shot, etc. It will make more sense once you see your spreadsheet.

Did I give you the link to the dictionary that explains our terminology? If not, here it is: http://www.felinediabetes.com/FDMB/threads/l-l-land-slang-dictionary.162551/#post-1744648
 
Tina & Doodles said:
So keep testing tonight...confused again
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You want to see 2 rising numbers without food before heading to bed. No need to feed anything at that 93 but you will want to test in 1 hour. If he's rising test again 1 hour after that. If he's the same or rising it's safe to go to bed. I'm not going to be able to stay with you much longer but @Tricia Cinco(GA) & Harvey will check in with you!
 
Note to Tina and all helping: Doodles’ SS is now up and I think I have all the info up to +4.5 entered for Tina. That should help everyone see the patterns and discuss a dose.

Tina: As Wendy was explaining, lantus is a depot insulin. That means that part of the shots you give when starting out or increasing a dose go towards building this depot and part goes towards working to bring the BG down. When the depot is overfull, numbers come way down and a reduction is needed. In a case like this where it seems you have way too much of a depot (I think the vets raised the dose way, way too high too fast when the dose should have been dropped), it’s a good idea to “drain” it. Think of it like a bucket of water that is overflowing; you have to drain the bucket to keep the water from going over the sides.

The depot from a larger dose can affect the BG for up to six subsequent cycles after it has been reduced but I have seen at least two cases where it affected the BG even longer. We’ll stay optimistic that this won’t be the case with Doodles. By reducing the dose to 1u, it lets the “dust” settle by draining the depot and then we can get a clearer picture if he needs more or less insulin.

BTW, the numbers he had on the first curve on 9/27 when he was on 2u really look to me like he was getting pretty low on that dose and then bouncing way back up. Just a guess, but I’ve seen a lot of spreadsheets and a lot of low numbers followed by those high ones.

It’s a good idea to grab another test in an hour just to be sure he continues up.
 
Marje and Gracie said:
Note to Tina and all helping: Doodles’ SS is now up and I think I have all the info up to +4.5 entered for Tina. That should help everyone see the patterns and discuss a dose.

Tina: As Wendy was explaining, lantus is a depot insulin. That means that part of the shots you give when starting out or increasing a dose go towards building this depot and part goes towards working to bring the BG down. When the depot is overfull, numbers come way down and a reduction is needed. In a case like this where it seems you have way too much of a depot (I think the vets raised the dose way, way too high too fast when the dose should have been dropped), it’s a good idea to “drain” it. Think of it like a bucket of water that is overflowing; you have to drain the bucket to keep the water from going over the sides.

The depot from a larger dose can affect the BG for up to six subsequent cycles after it has been reduced but I have seen at least two cases where it affected the BG even longer. We’ll stay optimistic that this won’t be the case with Doodles. By reducing the dose to 1u, it lets the “dust” settle by draining the depot and then we can get a clearer picture if he needs more or less insulin.

BTW, the numbers he had on the first curve on 9/27 when he was on 2u really look to me like he was getting pretty low on that dose and then bouncing way back up. Just a guess, but I’ve seen a lot of spreadsheets and a lot of low numbers followed by those high ones.

It’s a good idea to grab another test in an hour just to be sure he continues up.
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Thank you for setting it up. I will enter data for next 2 tests & then tomorrow mornings. I appreciate your assistance with the set up.
 
Been trying for 1/2hr to get a BG. Keep getting various b.s. errors & cat is irritated. I will try again in morning. Get new monitor after am process.

Gone through almost 50 test strips in 36 hrs
 
Tina & Doodles said:
Test 2 hrs before eating, just before I feed & then when?
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To answer your Q:
As a rule you want to make sure you get a test right before he eats. That way since you shoot the insulin right when they are eating or close to that, you know if the blood sugar number is high enough right then to safely give the shot. That's why the test right before shoot!
If that test shows a low number you should post to get help with how much insulin to give. .Lantus works best when you stick to a 12 hr between the shots so we shoot at 12 hrs apart. Hence the AM/PM cycles.

The recommendation is to get a +2 ( 2 hrs after you give the shot) as it can be a barometer of what the cycle is going to look like, and that will let you know how much to test. If the +2 number is the same or lower than your pre shot number you may have an active cycle.
@Chris & China is very good at explaining it

Just saw your troubles testing..soooooo sorry! It will get better...
 
Just saw the tag so I'll try my best to explain

We've seen it happen a lot that the +2 can act kind of like a crystal ball for predicting what kind of cycle the cat is going to have (for some cats, the +3 is better)

If the +2 is about the same as the Pre-shot number, it's usually going to be a pretty normal cycle....gradually going down to nadir (the lowest point) and then up again

If the +2 is higher than the Pre-shot, it can indicate that they're starting a bounce...and bounce cycles are the ones you can usually get away with not testing as much and (hopefully) getting an early night!

If the +2 is lower than the Pre-shot, that's your early warning signal that your cat might be going a lot lower later in the cycle, so those cycles are when you'd want to be able to get more tests in until you're sure they've dropped as low as they're going to and are headed back up again

With all that being said, the big caveat is that nobody explained these "rules" to our cats ;)
 
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