PMPS 66 stall or skip?

[Kate Martinez]

This is my first post here so I hope I am doing everything right!

I bumped my girl's Lantus dose up .25 this morning and her numbers have been low all day.

Hoping for guidance on whether I should shoot low, stall or skip?

Thank you in advance!!

 

[Chris/China (GA)/Garfield]

you should stall, DON'T feed, and recheck in 20-30 minutes, but that being said, you need to decrease her dose immediately.

The 20's you got on the 1U dose on 8/18 earned a reduction down to .75

Anytime they drop below 50 (on a human meter), they earned a reduction in dose

 

[Tricia Cinco(GA) & Harvey]

Hi and welcome.

First off, that 34 means you go back to 1 unit the next time you shoot. Have you fed her yet?

Chris and I posted at the same time. I agree with her that you should go back down to .75. Also, any time you get a low number like that 34, you need to retest immediately to be sure it was an accurate test. If it was, you feed and test again in 20-30 minutes. It is not a good idea to go several hours after a number in the 30s without testing and monitoring.

 

[Kate Martinez]

Hi and welcome.

First off, that 34 means you go back to 1 unit the next time you shoot. Have you fed her yet?

I have not fed her for 4 hours, I will wait and retest in 30 minutes

 

[Kate Martinez]

you should stall, DON'T feed, and recheck in 20-30 minutes, but that being said, you need to decrease her dose immediately.

The 20's you got on the 1U dose on 8/18 earned a reduction down to .75

Anytime they drop below 50 (on a human meter), they earned a reduction in dose

She ate, but not eat a full meal before PMPS on 8/18 so I thought that may have been the reason for the low numbers. I wasn't sure if I should reduce her dose or keep it the same since it was so high on 8/19.

 

[Tricia Cinco(GA) & Harvey]

Kate, I see now you have in the remarks that she came up to 49 after you fed her at +7. If you could please put that in the cell it would be easier to spot. You can put more than one reading in a cell by using the wrap feature. It's the icon at the top of the SS that looks like a sideways U-turn arrow. It would look like this:
34
49@7.25

You can look at Harvey's SS and see how it looks.

She ate, but not eat a full meal before PMPS on 8/18 so I thought that may have been the reason for the low numbers. I wasn't sure if I should reduce her dose or keep it the same since it was so high on 8/19.

That was most likely a bounce, a reaction to the low numbers. She'll probably bounce after today's drop, too.

 

[Kate Martinez]

Hi and welcome.

First off, that 34 means you go back to 1 unit the next time you shoot. Have you fed her yet?

Chris and I posted at the same time. I agree with her that you should go back down to .75. Also, any time you get a low number like that 34, you need to retest immediately to be sure it was an accurate test. If it was, you feed and test again in 20-30 minutes. It is not a good idea to go several hours after a number in the 30s without testing and monitoring.

I tested again, fed her, and tested again 20 minutes later, she was at 49. I have not fed her yet tonight. We can decrease the dose tonight, will it be safe to shoot? Thank you so much for the help!!

 

[Chris/China (GA)/Garfield]

We can decrease the dose tonight, will it be safe to shoot?

No....not even the most experienced of us will shoot a number under 50

skip tonight and let the depot drain....and read the stickies at the top of the forum about how to use Lantus safely

If she's over 150 in the morning, I'd only shoot .75 and hold that dose no matter what her Pre-shot numbers are for at least 3 days

 

[Tricia Cinco(GA) & Harvey]

I tested again, fed her, and tested again 20 minutes later, she was at 49. I have not fed her yet tonight. We can decrease the dose tonight, will it be safe to shoot? Thank you so much for the help!!

Here you are referring to earlier today, correct? I think Chris was confused. You haven't tested her again since the 66 yet?

 

[Kate Martinez]

I am so sorry for the confusion I am still getting this all figured out. Here are her current numbers for today:
34 +7, 49 +7.25, 72 +11, 66 PMPS, stalled and did not feed, 64 +12.5 - not sure whether to feed and skip or continue stalling and shoot low tonight?

 

[Chris/China (GA)/Garfield]

I don't think you have enough data to shoot that low just yet

I'd go ahead and feed her and skip tonight.....just call it a furshot and have a quiet evening.....get a couple tests in when you can because all data is good data and it'll help knowing how she responds to a skipped shot anyway.

Just put N.S. (No Shot) in the Units column to show you didn't shoot on purpose

 

[Tricia Cinco(GA) & Harvey]

I am so sorry for the confusion I am still getting this all figured out. Here are her current numbers for today:
34 +7, 49 +7.25, 72 +11, 66 PMPS, stalled and did not feed, 64 +12.5 - not sure whether to feed and skip or continue stalling and shoot low tonight?

My inclination would be to skip and let the depot drain a bit, then assuming you get a shootable number in the morning, resume with the .75 units. BUT first I must as if Bella has any history of ketones?

 

[Kate Martinez]

Thank you both!! I am just starting to learn how to test for ketones, I have never tested before. We have had no issues in the past that I know of.

 

[Tricia Cinco(GA) & Harvey]

Thank you both!! I am just starting to learn how to test for ketones, I have never tested before. We have had no issues in the past that I know of.

That's great. Then I would skip tonight and start tomorrow with .75. You might grab a test or two tonight if you can - just to see how she's doing. There is no such thing as too much data. She may bounce from today's low, or she may not. She is a cat, after all.

In the meantime, if you haven't already, I suggest you read all the stickies at the top of the Lantus & Levemir page - especially the one about handling low numbers. Even if you have read them, do it again - I must have read them five or six times and I still find things I missed! There is a TON of info there.

Also, here's a post we put together for new members to help them get comfortable with the site. Sort of a FAQ. http://www.felinediabetes.com/FDMB/threads/updated-tips-for-new-members.173572/

If you can set up your signature block, that would be very helpful. The post tells you what info we like to see in them - it helps prevent the same questions getting asked over and over.

Start a new "condo" (aka thread) in the morning, and link this one to it (ask if you don't know how). That way people can look back and see what was already discussed.

Ask lots of questions! We love to help!