Which dosing guidelines are you using, Steve? There's the Start Low Go Slow method or the Tight Regulation Protocol. You're going to want to read up a little on both of them and decide what works best for you, then put it in your signature line so you don't get asked endlessly!
I'd encourage you to post and ask for dosing advice before you increase. What I'm seeing right now would suggest you would only increase 0.25u when it's the right time.
Some of us wrote a little blurb for new people - not all of it applies to you but there's a little bit that might be helpful.
Welcome to Lantus and Lev land – the best place you probably never wanted to be! If you are like most of us, if this is your first few weeks of trying to wrap your head around the fact that your kitty has diabetes, you’ve no doubt been terrified, in tears, in a state of shock, and completely overwhelmed. Don’t worry. It gets easier. It really does.
None of us here are veterinary professionals but many of us have been working with our cat’s diabetes for a long time. Even those of us who have been here for a short time are here to help. This is a wonderfully supportive community.
There are a few first steps. We firmly believe that home testing is the best way to keep your cat safe. We keep a record of our cat’s blood glucose (BG) data on a spreadsheet (SS) which you can create using these instructions:
http://www.felinediabetes.com/FDMB/...te-a-ss-and-link-it-in-your-signature.130337/. If you’ve not mastered home testing, we’re happy to offer suggestions or you may want to spend some time on the Health board mastering the basics of testing, low carb diet, and getting your SS set up. We’re happy to help you with those things, but you should be aware that this is a busy board and if there’s an emergency, everyone’s attention goes to helping the caregiver and his/her kitty.
Once you’ve got a handle on the basics, you will have the option of following the Tight Regulation Protocol or the Start Low Go Slow (SLGS) method for managing your cat’s diabetes. You don’t have to stick with whichever approach you initially choose but it is helpful to give your choice a chance so you can evaluate the results fairly.
The Tight Regulation protocol was developed based upon the premise that a cat's pancreas may be able to heal and return to producing insulin if the cat's BG is kept in a normal range (i.e., 50-120}. Caregivers following this protocol adjust insulin doses following the protocol guidelines to aim for that range. Basic information on the TR is here:
http://www.felinediabetes.com/FDMB/threads/lantus-levemir-tight-regulation-protocol.1581/. The advantage of this approach is that it is based on research published in a leading veterinary journal and has an admirable track record of getting cats who are within the first year since diagnosis into remission.
The Start Low Go Slow (SLGS) approach has caregivers start with an initial dose based upon the BG at diagnosis and whether kitty has been transitioned to a wet low carb diet, hold that dose for a week or two while testing for ketones regularly, being consistent with food and testing before shooting every 12 hours. Once a week a curve is done (test every 2 hours for one cycle) to check for the lowest point. the low number in that curve determines any dose change for the following week. This approach was the original method used in the FDMB prior to the TR protocol. It is an alternate approach if TR is not the right fit for you or your kitty. Basic information on the SLGS approach is here:
http://www.felinediabetes.com/FDMB/threads/lantus-levemir-start-low-go-slow-method-slgs.129446/.
Both approaches require that you test at pre-shot times and do your best to test at least once each 12-hour cycle. Lantus and Lev dosing is based on the lowest number in the cycle (i.e., the nadir) so getting at least one spot check is important to guide your dosing decisions.
If you are switching to lantus or levemir from any other insulin, please post for suggestions on the starting dose before you change insulins. You should also get your vet’s recommendation.
Amy&Trixie, Dyana&(GA)J.D., Julie&(GA) Punkin, Marje&Gracie, Sandy&Black Kitty, Sienne&Gabby, Wendy&Neko
