Breathe Hon! Calm down (I have to tell myself this on a regular basis! :lol: )
If you look at Lucian's SS, (his spread sheet in my signature), you'll see that I'm not only a newbee to all this, but having to deal with very high numbers, too. It's scary, frustrating, depressing and just plain hard to handle, but everyone keeps telling me it will get better. So I'm trying to hang in there.
I wouldn't pretend to know what advice to give you, but I did copy the general guidelines for dosing:
""""General" Guidelines:
Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).
Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).
Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.
Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Reducing the dose:
If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.
If an attempted reduction fails, go right back up to the last good dose.
Try to go from 0.25u to 0.1u before stopping insulin completely.
Random Notes:
Because of the cumulative nature of Lantus and Levemir:
An early shot = a dose increase.
A late shot = a dose reduction.
A "cycle" refers to the period of time between shots. There are 2 cycles in one day when shooting twice a day.
Sometimes a dose will need to be "fine tuned" by adding some "fat" or "skinny-ing up" the dose.
Using a weight based formula for determining a starting dose of Lantus or Levemir when following the Tight Regulation Protocol:
the formula is 0.25 unit per kg of the cat's ideal weight
if kitty is underweight, the formula frequently used is 0.25 unit per kg of kitty's actual weight
if the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration
Online Calculator for Converting Pounds to Kilograms
There are circumstances such as ketones present, an unusually low preshot number, a caregiver leaving the cat with a sitter, relatively high flat curves, loss of appetite, infection, a schedule change, ability to monitor, etc. which may call for adjustments to these guidelines.
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These are "general" guidelines which have worked for many cats.
Every Cat Is Different. Learn how YOUR cat responds to insulin.
We are laypersons - not veterinarians. Please discuss dosing, methods, and care for your cat with your veterinarian."""""
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I know that it takes a few cycles for the insulin to build it's 'depot', so you have to keep that in mind when you first start with Lantus.
Also, since the dose is based more on 'nadir', the lowest numbers between doses, usually at about six hrs after the shot, than the pre shot number, you will need to get tests between the shots too, to see just how far he is dropping between doses. The pre shot numbers are pretty much secondary in deciding on the dose.
If you can get a spread sheet set up and keep track of Big's BG test results, someone with experience can help you to find the appropriate dose, but they need those numbers in order for them to help you, to help Big.
If someone doesn't get it to you before I do, I'll find the info on setting up the spread sheet. It's not hard, if I can do it, anyone can! :lol:
You're not a complete newbee, you already know how to test, you're just new to Lantus and the board.
Testing was the hardest for me. It made me crazy! :-x
I know how scary those ultra high numbers are, my meter won't read anything over 599, it says 'HI' when it's 600+ and my heart drops every time. :sad: But I know we'll get it worked out and so will you.
Don't worry about going to Walmart, sometimes you need something NOW.
I do order anything that I can wait a couple days for from the links, just so I can help out in some small way. Seriously, I could not have made it thru the last 5 weeks without the help from so many wonderful, bighearted people here.
I'll go look for the spread sheet info and whenever you have time, read the stickies at the top of the Tight Regulation Forum. Basic info is pretty much the same, no matter what protocol you are using. The amount of information available on this site is amazing and will help you so much.
Hang in there, it'll get better. :YMHUG:
OH, you already got the SS! ohmygod_smile You need to click 'File' then click 'publish to the web', then a window will pop up and make sure it is checked 'Automaticlly republish when changes made'. Right now, it can't bee seen.
He is only now starting to show us something, thank goodness!
