Need some advice on my numbers

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GregFurBall

GregFurBall

Member Since 2012
Hi All-
We just posted last night and it was recommended we post over here. I have not figured out how to set up the profile yet so am not sure if you read the new post over on the main board or what information you need right now. We seem to be having concerns about our Lantis doseage. The vet told us to start at 2U twice per day but since we have changed his diet to raw food and began testing ourselves, we get low readings at the 12 hr mark (todays AMPS was 110).

Hopefully our spreadsheet that we've got started will help.

Thanks.
 
Re: New to Forum

Welcome to Lantus-TR, Greg, Karen, and Furball! You'll notice we have another Furball here too :smile: Her bean's name is Carla. Beans are what we call the human caregivers here, as in hooman beans/human beings :lol: I'm glad you made it over here.

We like to link our previous thread in our current thread - for you, the previous thread is the one you posted on Health: Greg/Karen/Furball's Health Forum Thread, 23rd September 2012.

You say you're having trouble with setting up your profile - did you see the link to the instructions I posted in your thread on Health? If you have trouble with them, please let us know, so we can help you out.

Also, I see no numbersin your SS for last night's cycle - were you able to get some spot checks? And: HAVE YOU SHOT that 110 preshotthis morning? If so, with what dose?(Since there is so little data on Furball as yet, we'd not normally suggest you shoot a preshot of 110 at this stage.)

As you touched on in your previous thread (or "condo," as we here in LL call our daily thread), your vet may not know enough about Lantus specifically. 2u is a high dose to start out with. I would recommend that you consider starting lower than that, so that you can consistently shoot every 12 hours and start building the shed (depot), as well as starting to see "normal" Lantus-action rather than wonky numbers from frequently changing doses.

Sienne has suggested the dose of 0.25u - I would go with that when next you get a shootable preshot and re-assess after you've been able to shoot consistenly for a few cycles.

The numbers you saw yesterday, starting in the green and ending in the red/black, are what we call a BOUNCE :smile: Bounces happen when a cat drops lower than it is used to, or faster than it is used to, and the liver reacts by releasing counterregulatory hormones and glucagon, pushing the BG back up. Bounces can take up to 3 days to clear, so you may see those higher numbers for a few cycles. When a bounce starts to "clear" (the hormones/sugars are flushed out of the cat's system), BG numbers can drop quite quickly and dramatically, so it's something to watch out for in the next couple of days.

Again, shooting one dose consistently is key, as is allowing Furball's shed to form. While that's happening, you can use the time to read, read, read :mrgreen: And ask any questions you have, of course. Whatever you decide for this morning, it would be good to get some early BG tests to see whether Furball may already have started to clear her bounce, ok? I would start with a (+1).

So far so good?
Hugs
Jane

EDITED to add: I'd go with a starting dose of 0.25u to be shot consistently every 12 hours, when next there is a SHOOTABLE preshot. (Thanks, Dyana - I wasn't being clear enough.) And to add the dose recommendation of 0.25u - Thanks, Sienne.
 
Re: New to Forum

I was just reading your post on Health and noted you opened a thread (we call a thread a "condo") here. So, welcome to Lantus Land!

A quick question. On the evening of 9/21 you noted that you stalled your PM shot until your usual +4. When you shot the following morning, did you shoot at your usual time or did you shoot 12 hours after your shot the previous evening?

I'm going to guess you shot at your usual time. For the future, whenever you stall, your next shot is 12 hours after you shot. With Lantus, an early shot acts like a dose increase and a late shot acts like a dose reduction. If you shoot late and then shoot early at the next shot time, it doesn't even things out.

As for this morning, we usually don't advise someone who's this new to shoot lower numbers. What Fur Ball's spreadsheet suggests to me is that you need less insulin than the 0.5u. You skipped a shot, had a high PMPS last night that dropped Fur Ball to a 110 this morning with a dose of 0.5u. For now, I'd suggest dropping the dose to 0.25u so you can, hopefully, start shooting that dose twice a day.
 
Re: New to Forum

I don't know, Jane. Usually, we recommend that people with little data, don't shoot if the pre shot test is below 150.
I have to go to work, so have to sign off. I would continue to get some more tests in throughout the day, whether to give insulin or not. How flexible is your shot schedule? Meaning if you give insulin an hour late this morning, can you give the insulin at 12 hours after that shot tonight, and tomorrow morning? If he goes up, then, maybe it will be advised to give insulin, but you will need to be home today to monitor, have plenty of test strips, and some high carb food for just in case.

Hope you have a good day :-D .
 
Re: New to Forum

You're right, Dyana, I wasn't clear enough that I meant a *shootable* pre-shot, this early in Furball's FD-Dance :smile:

I think Sienne's recommendation of 0.25u is a good one.

Jane
 
Re: New to Forum

Thanks everyone.
As to the question about 9/21/12 shot: you are correct that we did not change the dose time on 9/22/12. In fact we did not give him the AM shot as his numbers were too low. We really are trying to keep his shots at 7am and 7pm due to our work schedule. We are not able to test much during the work week.

The syringes our vet prescribed for us are the 30U so we are having difficulties getting the smaller units until we can order new syringes. Do they have smaller syringes? Your suggestion that .25U may be a better dose is a good one.
Thanks.
 
Re: New to Forum

The smallest increments that U100 syringes come in is a half unit. Relion, Monoject, Terumo, and a few others have syringes that are in half units. With Lantus, we make changes that are typically in 0.25u increments so you need to eyeball the amount. A dose of 0.25u would look like this:

025unit-1.jpg


I would approximate the dose by making sure there's a bit of space between the 0-line and the top of the plunger.
 
Re: New to Forum

Greg or Karen - would you tell us if it's Greg or Karen posting? It's so much nicer to know the name of the posting person :smile:

We'll help you manage Furball's treatment even though you have busy work weeks. Many of us here work full time - it really can be done!

Jane
 
Re: New to Forum

Hi Jane-
Right now Karen is posting. :) Greg is trying to help with all the 'computer' stuff. I have to log off in about 10 min but should be back home in 3 hrs.

Thanks, Karen
 
Re: New to Forum

Ok, Karen! (Hi, Karen :smile:)

If you do have time today, getting some spot checks would be great. For those of us who work full time (and don't work from home, like I do), weekends are great chances to get a curve or two, to get a sense of the trends a cat may be showing - you could consider that for next weekend. (A full curve would be to test every 2 hours through one whole 12-hour cycle. A mini curve would be to test every 3 hours.)

Let us know about the profile, if you do have trouble with the instructions, alright?

And keep posting your questions :mrgreen:

Jane
 
Re: New to Forum

GregFurBall said:
The syringes our vet prescribed for us are the 30U so we are having difficulties getting the smaller units until we can order new syringes. Do they have smaller syringes? Your suggestion that .25U may be a better dose is a good one.
Thanks.
Click to expand...

Hi Karen,

Welcome to Lantus Land!

Unfortunately, the insulin syringes are made for human-size doses, not cat-size doses, which leaves us trying to make minute adjustments between the marks. They seem to all be 30 units per syringe. The one suggestion I can make is that you can find syringes that are marked in half unit increments, which helps a lot when we're trying to adjust things by .25U. If you have a Walmart around, they are usually the cheapest for the syringes and their store brand "ReliOn" are the ones I've been using that are marked in half units.
 
Re: New to Forum

Hi All-
I think I have figured out the profile and have spent some time reading the 'sticky' notes on the Lantis page. Very helfpful.
We have tested Fur Ball as much as we could today as we were in and out a lot. We last tested him 75 min ago and will be testing him again in 15 min prior to his PS and feeding time. Overall his numbers have stayed fairly consistent and low today. We are not sure what we are supposed to do tonight as we know Lantis needs to be given consistently every 12 hours. Any thoughts or suggestions? Whenever we skip a dose he tends to have a pretty high spike. I'll let you know what his PS BG is as the time gets closer.
Thanks, Karen
 
Re: New to Forum - need advice

Alright. So we just tested Fur Ball again for his PMPS. BG was 105. We are really confused and just don't know what to do. We think his dose is pretty low already but do not understand the bounce / rebound stuff yet. We are afraid of the spikes that he seems to get when we skip dosing but his BG is so low that giving a shot now would probably be harmful. What should we do?
Thanks, Karen
 
Re: New to Forum

Hi Karen, Greg, and FurBall-

I'm bumping you for more experienced eyes. Since you need advice, you need to edit the subject line in your very first post to reflect your new question - that's the way to get attention to your post.

Welcome to the group!

Amy
 
Re: New to Forum

Thanks Amy-
I tried to change the subject line in this post but it didn't take. I do not know how to change the first post subject line.
How do I do that?
Karen
 
You go to the first post of the day in this thread. You'll see a button labeled "edit." Click on that button and you can change the subject line then click on "submit." The only way to change the subject line that's visible on the board is to change the subject line in the first post.

Like I mentioned this morning, I would suggest you reduce the dose to 0.25u. If you're not comfortable shooting tonight, that's fine. It's not unusual to have a cat who's diet has been changed to low carb to have to keep reducing the dose in order to find an amount that can be given twice a day.
 
Thanks Sienne-
We agree with lowering the dose to .25U but we just weren't certain if we should dose tonight or not. I'm overly concerned about not wanting his numbers to go too low. We suspected his change in diet has been a significant part of the challenges we are experiencing.
Thanks for the input as we try to navigate the challenges of this new process. :)
Karen
 
Karen:

I don't think you have sufficient data to shoot low. While we encourage, "shoot low to stay low," it's important to have the data to guide your decisions. You have about 6 days of data and several skipped shots. There's no way to know how FurBall will respond. An alternative would be to stall but it sounds like your schedule won't give you that flexibility.
 
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