In the 50's PMPS, +1, and +2

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PeteandCourt

Member Since 2013
Spreadsheet is updated. PMPS was in the 50s so I skipped. But +1 and +2 are also in the 50's and now he's yowling (super loud, super weird) and pacing a bit. I fed 1 tsp of Karo, was that the right thing? I thought he ate high carb treats at +1, but he vomited them within the hour.
 
Hello!! I'm still fairly new, but we're on Lantus too. Just from looking quickly at your spreadsheet, I see you didn't hold the 1 unit dose for a full 10-14 cycles (5-7 days) Each time you don't shoot, you start over, so it's too soon for you to have increased to 1.5 (vets don't always know what's best)

I'd suggest after you get Peter up some, you go back to 1 unit and get as much testing as you can in so everyone can really see how he's doing on each dose.

Here's the link to the Lantus Tight Regulation Protocol a lot of us use

viewtopic.php?f=9&t=1581
 
In all likelihood, you didn't need to give Karo. It can sometimes take more than an hour for the effect of food to raise BG. It looks like your kitty is at 101 by +2.5? If so, that's a safe range.

When you get a pre-shot number which is too low to shoot (i.e., a 50), it may make sense to reduce the dose. I realize it's hard to see those pink numbers but the increase to 1.5u dropped your kitty into a low range. With Lantus, you want 5 consecutive days at your initial dose in order for the insulin depot to form. I think it would make sense to drop back to the 1.0u dose.
 
When you get a number below 50, you "earn a reduction" so if you'd been giving 1.5, I think you really should go back to 1 and hold it there for at least 5 days. If he goes below 50, give 1-2 drops of Karo with a little LC food, or a couple of teaspoons of HC gravy (just the gravy so you don't feed more than necessary so if needed, he'll still be hungry for the next time) If you put the HC gravy into a strainer, the gravy part will drip out and you can save that for emergencies

Keep retesting every 20-30 minutes until he's above 50 and continues to rise or stay level...The syrup and gravy will bring them up fast, but they'll also crash back down just as quickly, so it's important to stay close and test, test, test

Hopefully more experienced eyes will be on to help you too
 
Without an insulin shot this evening, it's unlikely that Pete will have a hypoglycemic episode. It didn't hurt to give him some syrup. Was not really necessary with the skipped shot.

I would have suggested some food too. Say 1-2 teaspoon of the low carb. Syrup wears off fast.

You can test every 30 minutes if you need to for peace of mind. It takes that long for the food to have an effect on the BG numbers.

There can be some residual insulin from this mornings shot and the insulin depot. You may see low numbers for a bit.

I can't stay with you this evening to guide you. My internet connection has been flaky and kicked me off twice in the last couple of hours.

Please print these out for reference, just in case the board continues to have problems.

how to treat hypos
shooting and handling low numbers

Looks to me like your vet raised the dose too quickly. I'd go back down to the 1U and start counting cycles again. We only recommend increasing in 0.25U increments, in most cases.
 
Now at 101 at + 2.5. Agree with suggestions to go back down to 1u.

Thanks for the support...this has been so frustrating and a total emotional roller coaster!
 
Hello again! You might want to come on over to the Lantus board. It's a little less crazy and full of people who are using Lantus for their own cats. Each day you start a new topic (we call them condo's) with the date/cat's name and AMPS numbers, and it has the same icons (like the 911, the ?, etc)


There are 2 protocols for Lantus, the "Tight Regulation" and the "Start Low, Go Slow" (SLGS)..The Tight Regulation gives the best chance of getting Peter off the juice, but it requires more testing and work on your part.

Hope to see you soon, and you'll get all kinds of support from people who have been there!!

Lantus Tight Regulation
 
The Tight Regulation gives the best chance of getting Peter off the juice, but it requires more testing and work on your part.
Click to expand...
Actually, that's a big misconception. TR protocol does not require that people test more than the SLGS protocol. Many people do test more but that is their choice. For TR and SLGS, 4 tests a day are all that are needed. PS and a spot check during the day cycle, PS and a before bed at night.

It takes some additional testing under certain circumstances, such as ketones present, unusually low pre-shot numbers, your cat doesn't seem right where you need to test more. More testing is done so we can be more on top of when a dose might need to be adjusted, etc. or we just know our cats and know when they need to be tested.

If you are not home during the day to get those pre-shot day cycle tests, then you should try to get some tests at random at other times during the day cycle. Maybe a "before you walk out the door" test or a "as soon as you walk in the door" test.

You also need to test more at the beginning of this sugardance to try and find the nadir for your cat, since it is that nadir or low point that dose changes are based on. The nadir is not always the same time from cycle to cycle either. My cat my nadir at +4, someone elses cat may nadir at +6, another cat may nadir at +8. Different insulins have different nadir average times also. Know your cat. Know your insulin.

The best thing you can do is to learn how your cat responds. It's that ECID (every cat is different) factor we keep telling people about.
 
Good job on skipping last night. Great to see greens too! Lets see how he does for the next 3 days with 1 unit. (hold the dose unless he drops under 50).

Btw your date column is empty for yesterday and today?

Wendy
 
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