Finally! A BG below 200! What do i do about pm shot?

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Grady'smom

Member Since 2014
I am so thrilled right now!

Grady's BGs have been running in the high 200's to 300's on 2 units of Lantus twice a day. I just checked his Bg now prior to his PM shot and it was 160!!! This is the lowest number we've had since we started this journey in August. My vet advised me no shot if he is below 220. I'm in such a state of shock right now I'm not sure what to do: do i just pass on his shot tonight and see how he is in the am or check again in a few hours and, if hes above 220 give him his dose?
He' doing so good right now i dont want to mess him up!!

Thanks!

Linda and Grady
 
It's difficult to give dose advice without seeing the bigger picture as far as what his BG is throughout the cycles. I see you are hometesting - yay! Are you testing more than just before you give a shot? If you could take some time to create and populate a spreadsheet, it will help advisors know what to do.

Here's instructions on how to set up the spreadsheet we use: http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207
 
Hi Tara:
I've been struggling to set up the spreadsheet. I use an IPad.....does that matter?? I'll have access to a desk top tomorrow so i'm going to try it from work.

I test him before his shots. During the week i work and can only get those two BGs in but i try to get a few more in between ones on rhe weekends. This is the first one we've had below 200 so it was a big deal for me. Finally made me feel like i'm doing things right!

He's very comfy all curled up in his blanket right now so I'm leaving him be for a little while longer and I'll recheck him.
 
You can get the Google Sheets app for your iPad to access the spreadsheet, but it's probably easier to set up on a regular computer.

Until you get a spreadsheet set up so people can advise you, one thing you can do if you get a low preshot value is to delay 1/2 hour, without feeding, test again and if he's gone up over 200 you can then feed and shoot. Note that if you delay more than 1/2 hour to retest, your next shot tomorrow morning is 12 hours from when you finally give the shot tonight. It might be easier to skip tonight.
 
OK folks, success with a spreadsheet FINALLY!! (at least I think so)!

I've put in his readings from last night and today to start with. Here's hoping I did it right!!

I din't dose him last night becuase I was too nervous about a potential hypo. This morning, 24 hrs after his last shot he was 341. Considering he was almost 500 when diagnosed, I didnt think this was too terrible. Will get another tonight and i plan on doing a curve over the weekend.

Thank you all for your help and advice. Grady and I appreciate it very much!!
 
OK a question: How to I change the link so it just says "Grady's SS"?

Can someone please check it for me to see if I did it right?
 
Great job getting the spreadsheet started. :thumbup

From the link I gave you, here are the instructions on how to get the link published as something you want:
7) If you would like a "word" link, such as Grady's SS, use the following code: text. replace "link" with your spreadsheet URL, and replace 'text' with the name of your spreadsheet.

it will look like this

Grady's SS
Click to expand...
I think you've mostly got it, but check the square brackets, one might be misplaced at the front of the string.
 
For the second night ina row, Grady's PMPS was below 200. In fact. last night it was 83! So,I did not given him any insulin. This morning his AMPS was almost 400. As I would not be home with him all day (someone is looking in on him but there's no way she can test), I didn't feel comfortable giving him his usual 2 units so I gave him 1.5 instead. He's getting a curve done this weekend when I am home.

These wild fluctuations concern me. Not sure what I should or shouldnt be doing right now. Any thoughts or suggestions are most welcomed!
 
Good plan reducing the dose this morning. How much does Grady weigh? Given that you got green with 1.5U after skipping last night, I'm wondering if 1.5U is still too high. We start Lantus with a dose based on kitties ideal weight, or if he is underweight - the actual weight.
 
Hi Wendy:

Grady currently weighs in 9 pounds. Hes a big boned boy so he's a bit underweight at the moment.

He started off on one unit, then the vet wanted him bumped up to 2. I went 1.5, then 2. This morning I gave 1.5..... BG was 97 @ 6 hrs post and just now his PMPS was 176. So, once again, no shot. He has pretty much reached his patience limit with testing for today. As i planned to try to get a curve done tomorrow i'd really rather not stress him out anymore tonight.
 
Great job! Ultimately, you want to find a dose you can still give every 12 hours. Even if it's something like .5u or even less. Good luck with your curve tomorrow.
 
OK, that 9 lbs is a little over 4 kg, so Grady's starting dosage should be 1 unit. How about trying that on for size in the morning? Hopefully you can get a few mid cycle tests to see where it's taking Grady and it's a low enough dose you can shoot both morning and night. As you gather more data on Grady, you'll be able to give him insulin when BG's are below 200, but not yet. BTW: kudos to Gram for getting that mid day test in today! :-D
 
Hi Wendy:

I saw your post AFTER I gave him 1.5 this morning.....wish I had logged on sooner!! I couldn't do his curve today as planned due to being called away for most of the day. I did have someone check in on him.....the report I got was that he had a great day, was very active, alert, and bright eyed. He was hungry so he was given 1/2 of a small can of kitten food at noon. I just did his PMPS.... 282 ....so I gave him 1.5 again. I'll be home with him tonight so I'm going to try to get at least one test later on. He looks really, really good to me right now so I'm happy. His curve is priority #1 for tomorrow.

Enjoy the rest of your weekend. Thank you and send our love to Neko!!
 
Today's Grady update:

His AMPS was 142. Last night, he was 282 so I gave him 1.5. Since we are still new to these lower numbers, I didn't give him his shot p this morning as my vet said no shot if below 200. His planned curve for today was obviously not done either.

He will be due for PMPS in about an hour so I really need some dosing advice. If he's >200, do I give 1.5 or drop it to 1? i'm leaning towards the 1. He's been so good today: alert, bright eyed, and active. I want so much to get him under control and steady those BG's.

Any thoughts??
 
According to the protocol many of us follow here, Grady's starting dosage should have been 1 unit. We do not change the dose based on the preshot numbers, but rather how low the dose takes Grady mid-cycle, or the nadir. Also, Lantus likes consistency where you shoot the same dose morning and night. Since you haven't found a dose yet that you can consistently shoot the same dose twice a day, that's another reason to go down to 1 unit. It's much safer to start at a lower dose and go up than to start on too high a dose.

Over time and when you've gathered more data on how Grady is responding to Lantus, you'll be able to shoot a 142, but not yet.

It's great to hear that Grady is feeling better too. :-D
 
Good evening all:

Grady's curve is finally done....Yaay!!! He's been on 1.5 units once daily (per his vet) for the past few days. Both Grady and I are exhausted but relieved it's finally done. I admit, I was leery about the once daily dosing but I wanted to at least give it a try based on his recent numbers. My thoughts have now changed based on today's results.

As you can see on his spreadsheet, his lowest BG was 55 at 4 hrs post. He was promptly fed and, two hrs later, was 84. At 12 hrs post he was 329 so I gave him 1 unit and I'm going back to 1 unit twice daily. Based on everything I've read here and my other research, I think this will work better. That sharp dip scared me!! Remember, I'm still a rookie at this LOL

Have a wonderful weekend!
 
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