Harry is on his way to going hypo. What can I do to prevent it?

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Ashley & Harry

Ashley & Harry

Member Since 2016
Hey everyone.

I recently started Harry on Lantus. It wasn't doing much (we'd give him 1.5 units and his glucose would go down maybe 50-100) so we upped his dose to 2u a few days ago. When we did, he was hanging out under 100, and didn't really go back up so we skipped his evening dose. After that, we dropped him to 1.5u again, as he was back in the 300s the next day.

So, I suck at checking his glucose in the mornings. I'm really bad about it and I have lots of mean words for myself for slacking on it, because I should have checked this morning but I didn't. Please don't get mad at me for it, I'm mad enough at myself.

Husband gave him 1.5u this morning. I checked him 2 hours after his dose and he's already down at 160. Which means that when the Lantus really kicks in (6-8 hours post shot, I think?) he's most likely going to drop super low.

What can I do to help prevent him from going hypo? We have chicken/salmon in gravy Friskies and karo syrup and tuna. I have lots of test strips and lancets but I am home alone right now (hubby's at work). When should I start giving him stuff? How often should I check him?

His sheet is a few days behind but I'm actively updating it as soon as I post this, so if it's not up to date, refresh it in a few minutes.

Sorry if my post is all over the place, I'm freaking out a little bit even though nothing bad has really technically happened yet because I'm pretty sure I can prevent it as long as I get in before it hits.
 
Hey there--

OK, 160 is not a bad number at all, you're doing fine! You don't know what he was at pre-shot, so we aren't sure right now even if that number represents a big drop, or if he's just hanging out in blues today.

What I would do now is to hold off on the high carb, but give him a snack of his usual low-carb food. If he is dropping fast, that should slow him down. Now that you are on top of things, you can keep an eye on any descent and intervene more if need be. But for right now, he's perfectly safe.

Breathe!
 
Thank you! I just worry that the insulin will cause a big drop later, when he doesn't have the sugar in his system to accommodate it. Up until we started him on Lantus he was happily cruising in the 300s and my guessumption was that he'd be at 350, get Lantus, and drop 100+. So if he's at 160, then he doesn't have much more than 100 to drop before things go south fast. But I'm keeping an eye on him, which he is not too pleased about haha.
 
Yeah, just see where he goes today! Lantus is actually pretty good at the lower numbers-- the phrase over in Lantus-land is "shoot low to stay low". If he was in blues when you shot, it's entirely possible he'll just "surf" in blues all day. Or he might drop down into green, as he did (safely) on 4/14, but you'll be ready for it if he does. I'm wondering, looking at your spreadsheet, if what you are seeing is the breaking of the bounce from that low.

Now that you've switched to Lantus, you're going to have to re-train your thinking quite a bit-- it really works very differently from Vetsulin. One of the biggest difference is the "depot"-- there is carryover from shot to shot. Because of this, it's generally much easier to get a cat regulated, or just to figure out what a particular dose is doing, if you stay consistent from dose to dose. What we'd like is to find a dose that you can shoot consistently without skipping that keeps him in good numbers.

Have you looked at the "stickies" over in the Lantus forum? There's lots of information there, but in particular you should check out the two dosing procedures used-- Start Low, Go Slow, and Tight Regulation. They'll give you guidance about when and how to change doses on Lantus, and (hopefully) get Harry regulated and possibly back into remission.

Whichever dosing procedure you choose, though, you should always get a pre-shot number! ;)
 
Oh, and when you get a chance, you should update your signature to say that you're now back on insulin, and that you're using Lantus. And, once you decide on a dosing strategy, you can put that in as well-- saves on questions when you post!
 
Hi Ashley! 98 is still a GOOD number! You're nearing nadir at +5 so he likely won't drop much lower. A bit of his regular low carb food will help him continue to hover right there for a while. I know it's scary when this happens - I remember well - but BREATHE! Grin and enjoy this! THIS is what you've put all your hard work into! WOOT WOOT! YARD DANCE!
 
Thank you! I just fed him but he might not eat it yet cause it's still cold from the fridge (raw food). It doesn't help that I have anxiety so instead of my brain saying "this is good!" it says "omg HE'S GONNA DIE"

Brains are silly.
 
Hi, 98 is a great number !! And you are monitoring him just fine so just take a big breath

Since he did dropped quite a bit from last night even if we don't not really know much since this morning you should consider he may "bounce" which means you may see some high numbers later tonight and for a few cycles.

Also from you SS I noticed that you have been changing the dose in 0.5 units and with Lantus is strongly recommended that you increase and decrease in 0.25 units, as soon as you can do take a look at the stickies on the Lantus forum they will help you a lot.
 
So, like everyone said, he was totally fine. I was just using the Vetsulin mindset of "there's gonna be a drop of like 200" and instead he dipped down and the lowest number I observed was 88.

That said, what do you recommend I give him now? He's sitting at 121. My Vetsulin mindset says skip it, but obviously I'm not very experienced with Lantus. Here's his full curve:

AMPS: ?
AM units: 1.5
+2.0: 164
+2.5: 158
+3.0: 157
+4.0: 125
+4.75: 98
+5.25: 88
+5.75: 89
+6.5: 100
+8.0: 120
+12.0: 121

Thank you again for your help. I can be a little helpless with this stuff.
 
Ashley&David|Harry&Noelle said:
So, like everyone said, he was totally fine. I was just using the Vetsulin mindset of "there's gonna be a drop of like 200" and instead he dipped down and the lowest number I observed was 88.

That said, what do you recommend I give him now? He's sitting at 121. My Vetsulin mindset says skip it, but obviously I'm not very experienced with Lantus. Here's his full curve:

AMPS: ?
AM units: 1.5
+2.0: 164
+2.5: 158
+3.0: 157
+4.0: 125
+4.75: 98
+5.25: 88
+5.75: 89
+6.5: 100
+8.0: 120
+12.0: 121

Thank you again for your help. I can be a little helpless with this stuff.
Click to expand...
Is probably play it safe with 0.25. 0.5 max.
 
Oh wait, you're lantus..... Ok lantus people will probably say give the regular dose but I'll let them comment. I didn't read that carefully and thought you have vetsulin.
 
Ashley&David|Harry&Noelle said:
So, like everyone said, he was totally fine. I was just using the Vetsulin mindset of "there's gonna be a drop of like 200" and instead he dipped down and the lowest number I observed was 88.

That said, what do you recommend I give him now? He's sitting at 121. My Vetsulin mindset says skip it, but obviously I'm not very experienced with Lantus. Here's his full curve:

AMPS: ?
AM units: 1.5
+2.0: 164
+2.5: 158
+3.0: 157
+4.0: 125
+4.75: 98
+5.25: 88
+5.75: 89
+6.5: 100
+8.0: 120
+12.0: 121

Thank you again for your help. I can be a little helpless with this stuff.
Click to expand...
You can stall without feeding for 20 minutes and retest. If he's rising, you can give the same dose. I'm only advising this more cautious route because you don't have a spreadsheet full of data to go by.
 
Replied on your lantus thread. As I said there, I'm afraid the boards are too quiet tonight to expect the real dosing pros to answer. He did rise a bit (albeit with a little food).

Going forward, it would be good to pick one of the dosing procedures, and then that gives clear rules in most situations. But it is a bit of a dance at first while you are collecting data-- you'll know when a number is safe to shoot after you do it, but the first time you want it to be at a time where you are comfortable to monitor closely.
 
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