Thumper day 2

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Barbara

Barbara

Member Since 2011
Well, while I'm pleased with the low numbers she's getting today I'm puzzled. She was too low to shoot this morning (I know some shoot lower but it just makes me too nervous to shoot below 100) and she's still just surfing along. She has given me some low numbers recently on Lantus that is totally not "normal" for her also. It's hard for me to believe one dose of Lev would drop her like this, especially since I lowered from 1.5 Lantus to 1 unit Lev. Something else for me to worry about....

PMPS - 310
1 unit - first dose of Lev
+2 - 439
+4 - 388
AMPS - 91
no shot
+17 - 85
 
WOW! Hi Barbara - what amazing numbers!!!

My vet told me to dose at 50% of what Grayson had been getting, so maybe.... you might need to reduce ??? I'm too new to know, but if Lev is anything like Prozinc, the long cycles meant time to reduce.

Hope my Buddy is doing well! Say hi to Jennifer & him!

Lu-Ann
 
Hey Lu!

Go over to Buddy's blog on DCIN, it was updated today I believe. Jennifer posts tons of pics of him on FB, he's the worlds most photographed cat! LOL!

I had thought of starting at .5 so I might need to reduce. I was about to reduce her Lantus dose since she's been getting some pretty good numbers. After all this time wanting good numbers when I finally get them I think something is wrong. :roll:

I haven't been on the board much. I just can't seem to catch up everything!
 
Hey Barbara, she likes it! She really really likes it!!

Absolutely lower the dose! This is another example of why I call Lev the Gentle Giant. FYI, it's important to get BGs later in the cycle with Lev. Even by +4 it's not doing much.

Are you skipping the dose entirely? I don't know what your shot schedule is, as it's already afternoon where I am.

She will be much higher tonight, but please don't shoot 1U again. .5u would be safer. I would almost say .25u but she's been pretty high and already going 1 cycle without insulin is bad enough.
 
Sheila - what is the protocol for reducing the dose?
25% ? 30%? 50%? .5u or 1u?

Will start a new thread, but I'm wondering if we started too high w/ Grayson. Have to update his SS. Please check back shortly!!

Lu-Ann
 
Grayson & Lu said:
Sheila - what is the protocol for reducing the dose?
25% ? 30%? 50%? .5u or 1u?

Will start a new thread, but I'm wondering if we started too high w/ Grayson. Have to update his SS. Please check back shortly!!

Lu-Ann
Click to expand...

On this kind of drop and BG hold for so long after ONE shot, if there's a protocol it's drop dose by 50% at least. Like I said, I would consider .25u but that's up to Barbara. I wouldn't recommend .25u because Thumper's had high BGs and is going for a whole cycle without insulin so she's going to be way high again tonight.

91 is a remarkable drop from 400s after only 1 shot. Consider there was no depot to draw from, that drop was all because of 1 dose. This is why some of us get cranky when we see vets starting cats on 3U!!!

Remember ECID, just because this happened to Thumper does not mean it applies to Grayson. What do you see which leads you to think you started too high?
 
Dose changes with lev (either raise or lower) work best when you think in terms of percentages. Just saying .5u or .25u regardless of the base dose can lead to over or under changing. For instance at 1u, a .5u change is 50%! But .25u is 25%. (I know you are thinking, "duh! Why is she telling me that?").

Now lets suppose the dose is only .5u and the change is .5u (based on the nadir as Tilly recommends) - that is now a 100% change! But if the dose were, say 3u, then a .5u change would only be a 17% change.

In my experience going for a 15-20% change works best. So at 1u you want to make a .2u change (even .25u can be too much) and at .5u you want to aim for a .1u change.

Because Thumper had such a low and extended low after the first dose of lev, I am suggesting a bigger change because it really seems like 1u is way too much.
 
Vicky & Gandalf (GA) & Murrlin said:
Are you skipping the dose entirely? I don't know what your shot schedule is, as it's already afternoon where I am.
Click to expand...

Yes, I did skip entirely. I thought that was the thing to do? I know with PZI sometimes we would just reduce a bit for one cycle.

Vicky & Gandalf (GA) & Murrlin said:
On this kind of drop and BG hold for so long after ONE shot, if there's a protocol it's drop dose by 50% at least. Like I said, I would consider .25u but that's up to Barbara. I wouldn't recommend .25u because Thumper's had high BGs and is going for a whole cycle without insulin so she's going to be way high again tonight.
Click to expand...

I'm confused...which happens a lot! :lol: Are you saying to drop to .25??
 
Sheila, I didn't see your post till after I posted. I'm even more confused after reading that! I guess it's just too much math for me!
 
Sorry! I was trying to answer Lu-Ann and Vicky and I posted at the same time.

I think that dropping to .5u for tonight is fine - she will likely have bounced higher again. If, in the morning, she has a lower PS, you could consider dropping to .25u and see if that can stabilize her numbers.

As for skipping the dose, I think that was fine for today - new insulin, very low numbers, and still dropping at 5 hours past the shot time, and no data to say what she will do all say skip to me. I would consider a token dose before about +18, but only a tiny amount. Since we don't know what directing Thumper's numbers are headed, even a token dose ( and I am talking .1u in this situation) is an unknown.
 
Barbara wrote:
Are you saying to drop to .25??
Click to expand...

I'm saying don't give only .25u because Thumper's been running high BGs and will have high BGs again tonight because of the skipped shot. After such a run of high BGs as she's had on PZI, her risk for ketone development is greater.

Because of how the longer acting insulins work a green BG at preshot is not reason to completely skip a shot. It's fine to completely skip the dose in Thumper's case because you have no data. Even a half dose this morning could have sent her to the basement. So you did the right thing by not giving a shot at all.
 
Sheila & Beau & Jeddie said:
Just a note: Vicky, she is coming from lantus most recently.

(we have to stop posting at the same time and, basically, saying the same thing!)
Click to expand...


But spreadsheet says ProZinc as recent as April :razz: OH wait, I'm looking at Grayson's spreadsheet! Maybe you should also tell me One cat at a time!!!

Otherwise agree about saying the same thing, but that's good. I am afraid I have a tendency to mention what I would do, as an experienced Levemir user, and confusing the OP even more by then telling them but you should not do that. :roll:
 
Hey Denise...if this keeps up we'll have our entire "old" group here! :lol:

As suspected she was high at PS.

PMPS - 374
shot .5

I just realized I missed the +1 but will get a +2
 
She's probably appreciating that you missed the +1!!!

Grayson always is! ;-) I've got very few +1 or even +2s, as his food spike usually lasts at least til then.
 
+4 - 345

I don't get those early ones all the time Lu, just cause she's changed insulins. She is the same as Grayson, most of the time she's still climbing till after +4. During the week about the latest I can get is a +4 though, then I give her a snack & go to bed. Weekdays it's usually at lunch time when one of us can get home to check her.

I guess I will stick with the .5 tomorrow.
 
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