? Help shooting low (PMPS 84) - advice please!

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sassycatlady

sassycatlady

Member Since 2017
Need advice on what to shoot here soon..... Zander has been in the 80-range since at least +10. At PMPS he was still hanging in the mid-80s and I decided to try stalling (for the first time ever) and waiting 15 min....15 min. come and go and he's still hanging there in the 80s. I'm stalling again here for another 15 to see if he goes up but really need to get something in him here at the next test (I need to stay on a pretty strict dosing time schedule). I think he's still clearing a bounce from a few nights ago because he is not usually this low at PMPS. He usually dives at night so I want to be conservative but I need to give him something b/c he does have a history of DKA and at times in the past when I've skipped shots he's just soared through the roof at night till morning AMPS.

Advice??
 
With the way you've been skipping around on his dose, there's really no telling what he has in mind tonight, but I wouldn't give 2.75 again....it looks like that may be just a little too much but only time and more consistent dosing will tell.

Lantus needs to be given at the same dose both AM and PM and the dose is based on the nadir, not the Pre-shot. Each dose needs to be held for at least 3 days so the depot can settle and you really see what that dose is doing.

Every time you change the dose, the depot has to "catch up".

Do you have plenty of supplies (high carb food, strips, etc) and are you able to test as often and as long as necessary tonight?
 
Do you have plenty of test strips and some higher carb food or honey or syrup and can you monitor tonight? Because of the DKA in his history, I would not skip the shot. I would give the BCS of 2 again and get some extra tests in tonight, IF he is eating fine. You may need to set an alarm to get a mid-cycle test tonight.
 
Dyana said:
Do you have plenty of test strips and some higher carb food or honey or syrup and can you monitor tonight? Because of the DKA in his history, I would not skip the shot. I would give the BCS of 2 again and get some extra tests in tonight, IF he is eating fine. You may need to set an alarm to get a mid-cycle test tonight.
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Yep, I'm armed and ready. I gave him 1U. We've been through this before so I know I can help control his BG with some HC food if necessary.
 
Chris & China said:
With the way you've been skipping around on his dose, there's really no telling what he has in mind tonight, but I wouldn't give 2.75 again....it looks like that may be just a little too much but only time and more consistent dosing will tell.

Lantus needs to be given at the same dose both AM and PM and the dose is based on the nadir, not the Pre-shot. Each dose needs to be held for at least 3 days so the depot can settle and you really see what that dose is doing.

Every time you change the dose, the depot has to "catch up".

Do you have plenty of supplies (high carb food, strips, etc) and are you able to test as often and as long as necessary tonight?
Click to expand...

Yes, I'm aware that consistency is key, but it always seems like something happens when I try to get a curve to find his nadir on a dose. On 4/28 for example - he was pretty much in pink and some yellow all day on the 2.75U dose, and that was after a week of holding this dose. How do I know if that's an anomaly or a true picture of what's happening during the weekdays? Do I go up to 3 or wait it out another week and try again? I gave him 3U for a time and then he dove into the lime green numbers, so that's a reduction of 0.25. This is definitely an exercise in frustration (where's the icon of a head banging against the wall? lol). ;) I have been a lot better at giving the dose at the same time everyday so I know it's all this dosage fluctuation that is causing problems, but should I shoot the same dose every time regardless of BG number (unless it's super, super low of course) to get a better picture of what's really happening? During the week when I'm not home to monitor and he has a low AMPS I play it safe, but I know I'll be paying for that later in terms of the depot.

Yes, I can test more easily at night so that's not a problem and will keep an eye on things tonight.

Thanks for the feedback.
 
sassycatlady said:
should I shoot the same dose every time regardless of BG number (unless it's super, super low of course) to get a better picture of what's really happening?
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Usually, the answer is going to be "Yes"......but of course you don't start out shooting lower numbers! We generally say if they're above 150, shoot the scheduled dose.

If they're below 150, the first few times you should stall, DON'T FEED and post for help.....Retest in about 20-30 minutes to see if they're coming up on their own without the influence of food. If the number goes up, it's usually going to be safe to shoot.

As you get more comfortable shooting lower numbers, you start to gradually lower the number you're willing to shoot. Most of us doing TR that have enough data and experience (and know our cats well) will shoot anything over 50. Feel free to take a look at China's spreadsheet! You'll see that at those lower numbers, what usually happens is there's very little movement.....instead of a "smile" curve, it's almost flat
 
Chris & China said:
Usually, the answer is going to be "Yes"......but of course you don't start out shooting lower numbers! We generally say if they're above 150, shoot the scheduled dose.

If they're below 150, the first few times you should stall, DON'T FEED and post for help.....Retest in about 20-30 minutes to see if they're coming up on their own without the influence of food. If the number goes up, it's usually going to be safe to shoot.

As you get more comfortable shooting lower numbers, you start to gradually lower the number you're willing to shoot. Most of us doing TR that have enough data and experience (and know our cats well) will shoot anything over 50. Feel free to take a look at China's spreadsheet! You'll see that at those lower numbers, what usually happens is there's very little movement.....instead of a "smile" curve, it's almost flat
Click to expand...

Ohmygosh! That is my dream spreadsheet right there! ;) One day it will be mine...I mean, Zander's. I hope. :D Shoot for the moon, land among the stars, right?

On the weekday mornings, I'm on a pretty tight schedule so don't have a lot of time to stall and wait, which is why I just go ahead and shoot a lower dose if I see a blue number. But I can see the importance of doing that so I will definitely try to shuffle my schedule a bit in the AM in those instances, at least until I have more data to draw from. Tonight was the first time ever that I've stalled and waited, but his number stayed relatively flat, which seemed weird to me.

Good tips and food for thought. Thanks.

Chris & China said:
:banghead::banghead::banghead:

Have you ever read the sticky on "Is Tight Regulation possible with a full time job"? Even if you don't do TR, there's a lot of good idea's
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Ha ha... wow, there's really an icon for that after all, huh? :cat:

I'll take a look at that other stickie you mentioned. I'm all about having quality information (I'm a librarian by day, a crazy sassycatlady by night, ha ha!) available to make good decisions, but even I will admit treating with Lantus is a lot more complex than it first appears - even when I'm armed with all the scientific and anecdotal evidence. It really is trial and error, as yes, ECID.:)
 
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