Mikey 12/6 AMBG 279/+11(23) 277 PMBG 208...DOWN...WTHeck??

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MikeysMom

MikeysMom

Member Since 2011
After another long night, Mikey was at 279 at his preshot time. I did not inject this morning after the big drops he was having; hoping that helps stabilize the shed. We all got a little sleep and Mikey's little ears got a little break. Please keep your fingers crossed that this helps him tonight. He's obviously at a level where he still needs some insulin. If anyone has any advice, I'd sure love to hear it.

I can't thank everyone enough for your support as we go through this. None of my friends and family has stayed up all night or offered the help that you all have. I'm overwhelmed, because I'm used to doing everything on my own, and your kind words and PM's all mean so much.
 
Re: Mikey 12/6 AMPS 279 NO SHOT +5 238...Now what to do toni

Good morning! This is not such a bad score for Mikey, considering that he had no shot this morning. (I would have done the same.)

I think that 43 may have earned Mikey a reduction of some kind - but of course, he just had one. I would suggest that you get a +11, then post and see what the recommendations are for tonight's dose.
 
Re: Mikey 12/6 AMPS 279 NO SHOT +5 238...Now what to do toni

I will do that. I definitely agree that he still needs another reduction. I'm going to call my vet today as well and see if there are any suggestions from that end.
 
Re: Mikey 12/6 AMPS 279 NO SHOT +5 238...Now what to do toni

I certainly hope this helps get Mikey settled down, and that you can get some rest today.

Just a housekeeping tip - if you didn't shoot, your "amps" should be "ambg" but don't worry about a silly little thing like that - go take a nap! :lol:
 
Re: Mikey 12/6 AMPS 279 NO SHOT +5 238...Now what to do toni

What time is shot time? (And your on eastern time, right?)

I'm thinking that reducing Mikey's dose to 0.25u may be a better start but I like the idea of a +11.
 
Re: Mikey 12/6 AMPS 279 NO SHOT +5 238...Now what to do toni

Checking in to see how you're all doing! Hope tonight is less eventful for you both. =)

Also - What meter are you using? Some strips are cheaper than others...
 
Re: Mikey 12/6 AMPS 279 NO SHOT +5 238...Now what to do toni

I talked to the vet (my vet was out today, but I spoke with the other vet, who has a diabetic cat himself and has done lots of research on Lantus. He agreed that Mikey's shed was overfull and to skip tonight as well to give a bit more a chance to clear the system. He said that some cats are very sensitive to Lantus and suggested that we do just one injection a day the next couple of days and see where his numbers fall. Mikey may be headed toward remission, but we can't tell yet. We see the regular vet tomorrow afternoon, so I think that I will follow his advice tonight (Mikey and I could both use a night off) and see where the numbers are in the AM before injecting then. It's tough because with the low numbers, Mikey hasn't been able to have an accurate curve to determine exactly when his nadir is.

I thank everyone for your continued support. I will post Mikey's numbers tonight and again at +11 and PS in the AM.
 
Re: Mikey 12/6 AMBG 279 NO SHOT Spoke to Vet, mixed review

I hope this all means that little pancreas still has some life in it! :) Hoping the very best for you two!!!!
 
Re: Mikey 12/6 AMBG 279 NO SHOT Spoke to Vet, mixed review

My personal experience with giving Kitty one shot per day was not good. Kitty bounced around like a red rubber ball.

When you talk to the vet next, maybe you can discuss the option of two shots daily, but at a lower dose.

But for tonight... I-) sweet dreams! :-D
 
Re: Mikey 12/6 AMBG 279 NO SHOT Spoke to Vet, mixed review

My experience and observations are like Kathy's -- one shot a day will give you swings in the numbers. An alternative to discuss with your vet is to lower the dose even further (e.g,. 0.1u) but shoot twice a day. If Mikey is doing well on an teeny dose but needs more, you can increase. You can see photos of micro dosing in the New to Lantus sticky.
 
Re: Mikey 12/6 AMBG 279 NO SHOT Spoke to Vet, mixed review

I tend to agree. The vet thinks that the problem is being caused by the insulin lasting longer than 12 hours in Mikey's system, though, and causing too much overlap. I was thinking of asking tomorrow about feeding a higher carb food with his evening shot, possibly a lower dose than his AM, to counteract the overlap? Thoughts?
 
Re: Mikey 12/6 AMBG 279 NO SHOT Spoke to Vet, mixed review

hi there! wow. just looked at mikey's ss. he sure has had you hopping!

it's a very, very rare occurrence for a cat to do well on one shot a day. if you're looking for opinions... i like sienne's suggestion to drop the dose to 0.25u twice a day.

however, i'm also interested in seeing a +11 (really it's a +23 since this morning's shot was skipped). if mikey were to drop into normal numbers between now and then... we may want to re-think this suggestion.
 
Re: Mikey 12/6 AMBG 279 NO SHOT Spoke to Vet, mixed review

We see the vet tomorrow, so I'm definitely going to ask about lowering to .25 and dosing twice. My thought was to dose .25 in the AM and run a curve...I know that after 2 cycles off that it might not be terribly accurate, but I can at least see if there are huge drops. We see the vet at 4, so that give us most of the day. Unless he's WAY high tonight, I'm going to follow the vet's advice and let the shed drain a bit more.

I would definitely like to find a 12-hr dosage that works better than go to once a day, but I know I can't do these all-night deals where he drops to 50 in 2 hours all the time, either. Surely there must be something that will work. My mom has a FD cat (but doesn't home test, so not much good for advice!)on Lantus, and she gets a smaller dose for her PM shot to combat the overlap. So, maybe that's an option as well.
 
Re: Mikey 12/6 AMBG 279/+11(23) 277 NO SHOT; Holding

At +11/23, holding relatively steady at 277. Not great, but not through the roof, either. Not the decision is to shoot .5 in the AM (as vet suggested) or .25 (because I'm chicken). Leaning toward the .25 and see where he drops to during the day. Thoughts?
 
Re: Mikey 12/6 AMBG 279/+11(23) 277 NO SHOT; Holding til AM?

My VERY humble opinion would be twice daily at .25. You are less likely to experience those upsetting dramatic lows, and more like to achieve the beautiful steady "surf" Lantus is famous for. You can ease your way up with a "fat" dose (like a .35) if you find .25 isn't quite enough. And yes, there are ways to measure that! :lol:

I also think (though open to correction) that the same dose night and day tends to yield the best results over time. I think you would know soon enough if you need a special dosing regimen for Mikey. My guess is that he is going to do very well on a standard regimen, once you find your groove. :mrgreen:
 
Re: Mikey 12/6 AMBG 279/+11(23) 277 NO SHOT; Holding til AM?

Hi again, I too think that twice daily works better. Tess sky rockets every time I have to skip a shot. You really haven't had much chance to see how it will work for a low dose. You must be in shell shock by now. I hope you two have a good night's sleep and that Mikey's ears are feeling better in the morning.

Tess has been on .1u to .25u for over a year. Do you have half unit syringes? Drawing the dose consistently is the key, but a real pain. What I do is draw.5 unit of insulin then squeeze it all out and count the drops. I draw to where I think the .25u should be and see if I can get half the number of drops. It doesn't matter how many drops you get, just that they are the same size and you can be sure to repeat it every cycle. Don't try to push the plunger, you get much better control by twisting it. A good magnifier helps too. :lol: I count drops for every syringe because the markings can vary and on such a tiny dose every little variation counts.
 
Re: Mikey 12/6 AMBG 279/+11(23) 277 NO SHOT; Holding til AM?

Now this is interesting (or throws a wrench in the works?) I took another BG right after dinner (too soon for dinner to kick in) and PMBG, at 24 hours, is 208, down from 277 an hour ago. I have NO idea what to make of that. He held steady all day, and then this drop at 24 hours. Weird. Ideas?

I'm going to get an old needle and practice some micro doses. Even getting the exact .5 and 1 are tricky, and if anything, I'm a little light with them. Same with .75 (and, by association, .25). I like the idea of counting the drops, but I'm not sure how that will help me be exact drawing the drops IN to the syringe. I looked at the pictures, but replicating them on my tiny syringes is tricky! I'll figure it out, though!
 
Re: Mikey 12/6 AMBG 279/+11(23) 277 PMBG 208...DOWN...WTHeck

I always overdraw and expel the extra, NOT back into the vial or pen. You waste a little insulin, but I never used the entire pen before the expiration date anyway. I don't think you are going to need to worry about running out of insulin the way Mikey is handling things.

Interesting, he may have a natural cycle that goes lower this time of day. Plus, giving food will stimulate a sputtering pancrease to produce insulin. So I definitely see some action there. This is good. :-D :-D :-D :-D
 
Re: Mikey 12/6 AMBG 279/+11(23) 277 PMBG 208...DOWN...WTHeck

the fact that you have a lower number without insulin is great. that probably means his pancreas is sputtering and producing some insulin on his own.

we've seen over and over that cats seem to do best with a consistent dose 12 hours apart. nearly every time people vary from that you get wonky numbers for a while.

if i were you, i'd give a .25 or .1 tonight - but i can understand you feeling a little gun shy after the past 2 nights.

as far as the support - lantus land is like that. everyone here learns and then teaches what they feel they can. and since we're all in the same boat, there's a lot of encouragement going on. it's hard, although it gets waaaayyyy easier once you understand what's going on.

we like to say it's the best place you never wanted to be. :-D
 
Re: Mikey 12/6 AMBG 279/+11(23) 277 PMBG 208...DOWN...WTHeck

I think I'm going to shoot .25 in the AM and talk with the vet further. There has to be some dose that can work at 12 hours, right? It was my vet's partner who advised me to skip tonight (he's got a FD baby himself), so I am going to follow his advice, especially after the last three. I'm going to test at +2 and see if he does have some kind of natural drop at that time. Here's hoping his little pancreas is thinking this over!
 
Re: Mikey 12/6 AMBG 279/+11(23) 277 PMBG 208...DOWN...WTHeck

One thought with shooting tonight...

If you shoot tonight, the shed is pretty empty. I would be very surprised if you see any excitement. (Although I completely understand your apprehension and need for sleep.) If there's considerable overlap, you'll see it in the AM cycle. However, it's your call and restarting insulin tomorrow is good.
 
Re: Mikey 12/6 AMBG 279/+11(23) 277 PMBG 208...DOWN...WTHeck

At this point, we'll wait. If he's dipping because of overlap, shooting so late would only make it worse, right?

At +2 since feeding, he's at 217, so not too big a rise due to food, but no natural dip, either. Perhaps that pancreas is up to something...
 
Re: Mikey 12/6 AMBG 279/+11(23) 277 PMBG 208...DOWN...WTHeck

At this point, given the skipped shot, there is no overlap. Overlap occurs between two doses.

If you are able, can you get a test at around +3? If Mikey's pancreas is kicking in, if you feed, you may see a drop a few hours after a meal.
 
Re: Mikey 12/6 AMBG 279/+11(23) 277 PMBG 208...DOWN...WTHeck

220 at +3 so virtually no change. hmmm... I promised Mikey no more sticks tonight, so we'll see what the morning brings.

I definitely wasn't clear in the overlap thing, I meant with tomorrow morning, if I want to stay on schedule (a necessity at this point). Let's hope the next few days are uneventful. I'm supposed to be out of town between shots Saturday, so hoping we see a good pattern by then.
 
Re: Mikey 12/6 AMBG 279/+11(23) 277 PMBG 208...DOWN...WTHeck

Just wanted to tell you good luck. I like the idea, too, of the .25u bid. FWIW :-D
 
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