Hypo event - starting to recover - dose advice?

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Lisa & Leo

Lisa & Leo

Member Since 2012
This is not 911, hypo event 2 1/2 hours ago, his values are 84.

Leo has been in the 300-400 range since he was diagnosed about 3 weeks ago. He started at 1.5 and has been at 2 units for 2 weeks. We laid off the frequent testing at the vet's suggestion to give him a break from the trauma, and retested curves after starting the new dose. The values were still high - his spreadsheet is in my sig. We couldn't test for the last 3 days because we were out of town and the sitter doesn't know how to do the BG testing. (She may learn but that's another issue). I returned home last night and had a better preshoot value (297 - yay!) I shot 2.5 units, which the vet approved based on the previous weeks values - that was the first shot at that dose. (I probably should have held off on the dose increase with that lower preshoot value.) I got up to test at +5 and his BG was 38!!! I gave Fancy Feast, retested 10 minutes later (43), more Fancy Feast (he's not really interested in eating much) and retest at +6 (69), retest at +6.5 (68). He's not eating the FF, but he's out of the danger zone it seems, but I'll test in 45 minutes as was recommended somewhere on this site.

Summary
PMPS 297
+5 38
+5 and 10 minutes 43
+6 69
+6.5 68
+7.25 84
+10 176

My question - he is due for a 2.5 unit dose in the morning. What do I do? I read for the tight regulation protocol to reduce the dose by .25 units, but since I don't have BG values for the last 3 days, I don't want to do that. Should I go back to 2 units or decrease it further? Also, I will be home tomorrow all day so I can closely monitor him whatever the dose.

I will call the vet, but they don't open until an hour after his scheduled injection time. Should I wait to talk to them before shooting, or keep him on schedule with a lower dose?

On a side note, could this be a turn towards remission? We've only had a few nadirs under 300. We can hope and pray Mr. Pancreas has started to perform his duties again!

Thanks!

Lisa and Leo

[Edited to add +10 BG value)
 
Lisa & Leo said:
This is not 911, hypo even 3 hours ago, his values are better.

Leo has been in the 300-400 range since he was diagnosed about 3 weeks ago. He started at 1.5 and has been at 2 units for 2 weeks. We laid off the frequent testing at the vet's suggestion to give him a break from the trauma, and retested curves after starting the new dose. The values were still high - his spreadsheet is in my sig. We couldn't test for the last 3 days because we were out of town and the sitter doesn't know how to do the BG testing. (She may learn but that's another issue). I returned home last night and had a better preshoot value (297 - yay!) I shot 2.5 units, which the vet approved based on the previous weeks values - that was the first shot at that dose. (I probably should have held off on the dose increase with that lower preshoot value.) I got up to test at +5 and his BG was 38!!! I gave Fancy Feast, retested 10 minutes later (43), more Fancy Feast (he's not really interested in eating much) and retest at +6 (69), retest at +6.5 (68). He's not eating the FF, but he's out of the danger zone it seems, but I'll test in 45 minutes as was recommended somewhere on this site.

Summary
PMPS 297
+5 38
+5 and 10 minutes 43
+6 69
+6.5 68
+7.25 84

I'll catch a cat nap now, and retest at +10.

My question - he is due for a 2.5 unit dose in the morning. What do I do? I read for the tight regulation protocol to reduce the dose by .25 units, but since I don't have BG values for the last 3 days, I don't want to do that. Should I go back to 2 units or decrease it further? Also, I will be home tomorrow all day so I can closely monitor him whatever the dose.

I will call the vet, but they don't open until an hour after his scheduled injection time. Should I wait to talk to them before shooting, or keep him on schedule with a lower dose?

On a side note, could this be a turn towards remission? We've only had a few nadirs under 300. We can hope and pray Mr. Pancreas has started to perform his duties again!

Thanks!

Lisa and Leo
Click to expand...

The 38 earns a dose decrease, so down by .25u you should go. As it is, on the next shot, you may still see lower numbers because of the shed drain. Having numbers from previous days don't matter because you have today's numbers, and 38 gets a reduction.

As for remission, you have a ways to go yet, and it could just be that the increase up to 2.5u as too much.
 
Blue said:
The 38 earns a dose decrease, so down by .25u you should go. As it is, on the next shot, you may still see lower numbers because of the shed drain. Having numbers from previous days don't matter because you have today's numbers, and 38 gets a reduction.
Click to expand...

I was wondering about just going back to 2 units (this was his first injection at 2.5u from 2u) because his values may have been a lot lower the last 3 days when we couldn't test. We could argue he might have needed a dose decrease from 2.0 to 1.75 yesterday. That's why I'm thinking decreasing .25u may not be enough.

Thanks for your quick response!
 
Update: Leo's +10 BG is 176, which is by far the lowest pre-shoot value we've had. Any more advice on this morning's dose?
 
Normally, we make dose adjustments in 1/4 units up and down. Normally, when we have a pet sitter that doesn't test, we lower the dose just a little bit to keep the cat safe. But, I can kind of see why you kept it at 2 units for the pet sitter.

This is just my opinion and others may have different ones; but since you won't be around today to monitor him, and his +10 is 176, I would go back to the 2 units and start testing again. The more data you have, the more we can help you with his dose.
 
I agree with Dyana - Hi Lisa, Hi Leo!

With your specific circumstances, I would try the 2.0u and see how Leo responds. ECID (Every cat is different), and I think in this case, being extra-careful is a good idea. You increased from 2.0u to 2.5u, and it gave him a *serious* dive to the low greens. He's been hanging out in the pinks/reds too much as it is, and that kind of fast drop/low dive just isn't going to help. Taking it back to 2.0u will hopefully give Leo a chance to get used to the dose and let it work for him, bringing him into safer, healthier numbers *without* the drastic dives. IF it doesn't pan out that way, we can re-assess.

How much will you be able to be home and monitor, Lisa?

Also, would you consider coming over to the Lantus group to post there? You'll have more Lantus-trained eyes on Leo and yourself there. Here is the Lantus TR Group Link if you'd like to come and introduce yourself.
Jane
 
Hi All, thanks for all the replies.

His AMPS was a staggering 407. I had planned to drop it back to 2 units, but went ahead with the 2.5u (before reading this thread - we were running late after going to the gym). Perhaps the first dose at 2.5 was a bit of a shock to him. My rationale for staying with 2.5u is that his AMPS was so high again, in the range of his previous 2.0u preshoot values, and also that I am home all day to monitor him. I will test him probably every hour from +4 through +6 and then periodically afterwards. If I could not be around, I probably would have dropped his dose to 1.75ish. I have a vet appointment later today for my other cat, and I will take Leo's values in with me for her review - they are supportive.

I wasn't sure about posting on the Lantus board because it seems everyone has to post every day with the values, and I can only regularly test him Thursday night through Sunday night. But I will go introduce myself anyway.

I'll update during the day. Should I be starting a new thread every day or just reply to this thread for now for this situation?

Thanks!
 
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