Newbie (again) Questions

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Theresa&Bashful

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Well, Bashful if back from the falls. Darnit. It was such a NICE honeymoon too! Had a full blood workup yesterday and everything looked normal, other than some off numbers for pancreas, which would be normal with bad BGs for a while.

I am now on Lantus. The vet said 1 unit (actually, she was going to start him higher, but I explained that he was very sensitive to insulin) Even though I know how to do a curve, I had them keep him to do the initial curve, mostly because this is a new insulin to me (he was on PZI before).

Now, get this, the vet only did numbers every 4 hours, and then wouldn't give me all the numbers she had done (I had to have them do an administrative request for a copy of the bloodwork results and the BG tests, which apparently takes a few days or more...and they wouldn't even write down today's bg's on a sticky for me. Don't ask me how incredibly annoyed I am with them right now. The only thing I know was that he was 185 when they gave him 1 unit this morning at 7 a.m. and two of his subsequent tests were 195/196 or so. Since they wouldn't give me any more info and wouldn't test him more often (I had to have basically an argument with her this a.m. to get her to add a couple more tests in there because I was concerned they gave him insulin when he was only 185), so I still don't know when nadir is.

Since it's been so long I have some newbie'ish questions.

1. Bashful was supposed to get his next shot at 7 p.m. (pacific). His BG was 151 at 6:00 p.m., he ate 3/4 or so of a can of FF at 6:30/6:45. I tested agian at 7:45 and he was 198, decided to wait a while and he was 232 at 8:30, so gave him a skinny 1 unit at that time.

So question is, does that sound like it was an okay approach?

2. Is Lantus a slower acting insulin than PZI? From what I've read it looks like he shouldn't hypo on this as easily as he did on the PZI? It's harder for me to make these decisions since I don't have a few days of data yet (Treat me like a newbie...that's how I feel..lol).

3. I'll start a chart tomorrow when I actually have some numbers to use. I'll do a curve with a test once an hour tomorrow to find out exactly what his nadir looks like.

4. Tonight I'll do spot checks every hour to 2 hours until I go to sleep. I hate giving him his first dose at home at night, when I'm not awake to check (yes, paranoid newbie), but since he was steadily rising, I didn't want to have a yo-yo effect if I gave him nothing.

Thoughts? Advice (especially any lantus info, since I am new to this insulin).

Theresa & Bashful
 
theresa, Hi - I am fairly new to home testing about a week and had 2 hypos in the last 2 weeks. When I experienced that same thing that happened to you at 7:45 and then at 8, I did the same thing. Everyone has told me not to worry about the high numbers soo much, but getting data, which is what you are doing, too bad about the vet did you scream at them just kidding.

Personally I think you did the right thing and you said that you were going to get spot checks every 2 hours. If you feel like it might drop too far at one point do you remember how to deal with a hypo? If not I can find the link for you if you like.

I don't know about Lantus My Spicey is on Pzi Vet. I will be up for awhille. I have 2 spot checks to do, am esxhausted.

Also at the bottom of my reply you will see a link for spicey's spreadsheet. Take a Look. And I will find the link.
viewtopic.php?f=6&t=16&start=0

Might help to keep everything together to look at the big picture.

David
 
Theresa&Bashful said:
Well, Bashful if back from the falls. Darnit. It was such a NICE honeymoon too! Had a full blood workup yesterday and everything looked normal, other than some off numbers for pancreas, which would be normal with bad BGs for a while.

I am sorry about this.

I am now on Lantus. The vet said 1 unit (actually, she was going to start him higher, but I explained that he was very sensitive to insulin) Even though I know how to do a curve, I had them keep him to do the initial curve, mostly because this is a new insulin to me (he was on PZI before).

Lantus is an excellent choice and one that will hopefully get him back to OTJ quickly.

Now, get this, the vet only did numbers every 4 hours, and then wouldn't give me all the numbers she had done (I had to have them do an administrative request for a copy of the bloodwork results and the BG tests, which apparently takes a few days or more...and they wouldn't even write down today's bg's on a sticky for me. Don't ask me how incredibly annoyed I am with them right now. The only thing I know was that he was 185 when they gave him 1 unit this morning at 7 a.m. and two of his subsequent tests were 195/196 or so. Since they wouldn't give me any more info and wouldn't test him more often (I had to have basically an argument with her this a.m. to get her to add a couple more tests in there because I was concerned they gave him insulin when he was only 185), so I still don't know when nadir is.

Since it's been so long I have some newbie'ish questions.

1. Bashful was supposed to get his next shot at 7 p.m. (pacific). His BG was 151 at 6:00 p.m., he ate 3/4 or so of a can of FF at 6:30/6:45. I tested agian at 7:45 and he was 198, decided to wait a while and he was 232 at 8:30, so gave him a skinny 1 unit at that time.

So question is, does that sound like it was an okay approach?

If you stick as close to your 12/12 schedule you will be shooting just fine. Typically, the protocol recommends that you do not feed 2 hours prior to shot time. This is to ensure that when you get the PS BG that you are getting an actual BG and not a food spike one.

So now that you shot 1 1/2 hour late from your 12/12 schedule, you need to shoot this same time for the AM. If you want to get back to your 7/7 schedule, you will need to do it in daily increments of 15 minutes. Otherwise if you do it at one time, it will be considered the same as giving a dose increase.

2. Is Lantus a slower acting insulin than PZI? From what I've read it looks like he shouldn't hypo on this as easily as he did on the PZI? It's harder for me to make these decisions since I don't have a few days of data yet (Treat me like a newbie...that's how I feel..lol).

Yes lantus is a slower acting insulin, it takes time to build the shed and stay in the system. I cannot comment on whether a hypo will or will not occur as they is dependent upon many factors, including food, amount of insulin, time shot, etc.

3. I'll start a chart tomorrow when I actually have some numbers to use. I'll do a curve with a test once an hour tomorrow to find out exactly what his nadir looks like.

4. Tonight I'll do spot checks every hour to 2 hours until I go to sleep. I hate giving him his first dose at home at night, when I'm not awake to check (yes, paranoid newbie), but since he was steadily rising, I didn't want to have a yo-yo effect if I gave him nothing.

Thoughts? Advice (especially any lantus info, since I am new to this insulin).

Theresa & Bashful
Click to expand...

If you haven't done it yet, please go to the lantus ISG forum and read all the announcements and "starred" information at the top of the page. This will give you everything from how to store and handle lantus to the dosing protocol and doing a curve.
 
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