Ducky AMPS 74 - missed shot now +8 338. Dont know what to do

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Angel and Ducky

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My Ducky had really low numbers all yesterday due to upping his normal 1 unit dose to a 2 unit dose per vet. This morning still really low so i skipped his shot. But now his numbers are climbing, my question - should I give him a mini shot now .25 or should I just wait the next 4 hours and give him his PM dose of 1.5 - 1.25. I am not sure how much to give because the 2 units seemed like too much but 1 wasn't enough so my vet upped him. He is on Lantus Glargine.
 
HI! Normally when we do a dose increase we increase by .25 increments. 2 units is probably too much, any reason why your vet wanted to up his dose? I am not an expert but I am sure someone will come by to help! I would definetely wait til his pm shot to shoot again. Lantus works best given in 12 hour increments. Try to get a +11 so you can see if his numbers are climbing before you do a preshot test.
 
His numbers at the vet were 383 and his symptoms hadn't changed in a week, so she upped the dose to 2 units... It seems like a lot from what I am hearing on this forum.
 
Yes 2 units is probably too much, most of us start on 1 unit. Lantus really takes a little while to start regulating. Scrabble took about a month and a half before we saw significant improvement in his numbers. Take a look at his ss. My vet wanted to up his dose in the beginning too but I decided to follow the advice on the board. On Lantus we hold the dose for 5-7 days before increasing. Did you get a chance to read all of the stickies? What time in your pm shot?
 
That makes sense, it did seem to build up. His PM shot is due in about 3 hours. We give him shots at 5:30am and 5:30pm with food before. I am thinking of giving him 1.25 shot and see where that goes. He was on 1 unit for about 8 days and his numbers only dropped below 200 once. So it seems like he needs a little more, but 2 is definitely too much. Since it seems like the right thing to do is increase by .25 units, that is what I will do.. But for this shot, since he didn't get his am shot.. should I give him 1.5?
 
I am not an expert on dosing and hopefully someone will come along before your pm shot but if it were me I would probably shoot a 1.25 and hold that dose for a week and see where Ducky goes. Are his numbers still climbing? Did you get a chance to look at Scrabble's ss?
 
I think your instincts are good, I would pick either 1.25 or 1.5 and see what that does. Try to hold that dose for at least a few days, unless the numbers are low. Get a preshot test *always* and try to get at least one other test each cycle.
 
Just checking in. Glad to see you here and you will continue to get excellent support form this forum.
How is Ducky doing?

Keep reading through the info as you can absorb, it is a bit like going back to school I know, but the more proactive you can be with knowledge, the easier all this becomes.
((hugs)) Kimmee
 
Thank you for checking in, Ducky is steadily climbing but I am about to give him his PM shot. yes, I have looked at the spreadsheets they are very helpful, and I can see the patterns, but it seems like so much ear poking... I feel bad for him.... I just gave him his PS test and he is at 433. I am thinking of giving him 1.25 shot and holding there for a week to see how it goes. I will make more of an effort to take his PS #'s since it seems that is a very important step. Hopefully his numbers will lower over the next few days. Should I be trying to keep him in a 100-200 range? I am curious as to whether or not the green or blue numbers are good on the spreadsheet. Thank you all for the advice.
 
Blues and greens are our friends! Those are the numbers we aim to get to to consider our cats "regulated".

Getting started: I highly recommend reading the links on this page: viewtopic.php?f=9&t=157 It's your first step into learning about the way we do things here on the board.

Ear pricking: Honestly, it doesn't hurt them much, it's more the stress of having their ears messed with, which cats don't like. Ducky will get used to it... especially if he gets a little protein treat after :) Yes his ears will be pinker than other kitties, but he'll be safe and healthy!

Testing: It's important to get readings throughout Ducky's cycle whenever you can. On that first link I gave you, there's a "Why do spot checks or curves" section, and you'll quickly realize why we test so much.

Food: Have you started feeding Ducky wet food yet? It's undeniably one of the best things you can do to start getting his BG's down. Simple canned wet food (doesn't have to be expensive) is waaaaay lower carb than even the diabetes prescription diet stuff the vet sells. Think of it as the "cat-kins" diet- low carb, high protein. Check out these food charts http://binkyspage.tripod.com/canfood.html that awesome people put together, and try and start feeding food with carbs less than 10%. A lot of us noticed a huge drop in BG's once we switched over to wet food.

Lots to absorb.... you've got a spreadsheet so that is great. Keep asking questions... we're here to help!
 
just a side note to say preshots and nadirs (not just preshots) are the most important tests (keep spot checking close to half way between shots to see when his normal nadir is). we need to test preshots to make sure they're not too low to shoot, and to see how well they are doing, but we base dosing decisions on nadirs on lantus (meaning, we're trying to keep them in a good range on the insulin so we try to balance what number they start at, how low they go, and where they end up). we can't really tell how they're doing if all we see are the preshots. for example, a high preshot number could mean they went too low and rebounded, or it could mean insufficient insulin, or any number of things like stress or fighting with other kitties. unless we know how low they went, we don't really know the whole story.

eventually we hope to keep them below 130 all the time to promote pancreatic healing, but that doesn't usually happen right away. they work their way there. that's why we call feline diabetes a marathon, not a sprint. :)

an occasional curve is a good idea. that's where we test them every 2 hrs to see when the insulin starts to take effect, how low they go, when they start climbing again, and how long the insulin seems to last.
 
I don't want to confuse things but wanted to say that knowing Ducky's nadir or approximately where it is will be very important in how you go with your dosing. I have 2 cats and both are very different.
Shadoe is a good girl and has her nadir around +5 or so, so I watch to see how low she is going in that area after her shots.
Oliver is totally different and his nadir is very very late. Right now, we are at +11.5 and he is still dropping. I will not worry so much about giving his shot soon because I know he is going to rise. If Shadoe were this low at her ps time, I would think twice about giving her shot.

And that's why it's a great idea to do some regular curves and find out just where it is that Ducky has decided to have his nadir. It's not bang on every day but after a few curves you start to see a pattern, get to know where Ducky goes lowest after shots.

Good luck with the decreased dose; I am sure Ducky's numbers will get sorted out soon.
 
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