New to FD, Lantus, and the spreadsheet

[ShaunaG]

Today at 7:00 a.m., we tested our newly diagnosed cat prior to her eating and the number was 5.6 mmol/L (human meter). She is on 1u Lantus twice daily. Should we proceed with the 1U of insulin when her reading seems in the normal range? At what point, do we NOT give insulin - would that be anytime her reading is below 4.4 mmol/L? At what point, would we increase her insulin? We are new to the feline diabetes issue. The vet told us to do a curve in a week and email results to her. Thank you.

 

[tiffmaxee]

Did you feed her-? If not wait about 20 minutes to see if she is coming up on her own. Are you following TR or SLGS? What type of meter, hunan or pet

Lantus is dosed based on the nadir, lowest point in the cycle and from your ss it looks like you don’t have any mid cycle tests to know what that is. On what basis was the dose reduced to one unit?

 

[tiffmaxee]

It looks like you did shoot I hope you are home and can test several times this cycle. Onset is usually at -+2.

@ShaunaG I hope you see this. Some would say to get a -+1.

 

[ShaunaG]

Thank you for your info. Being new to this, I will read up on TR and SLGS; not sure what those entail yet. We hope to keep to a strict schedule for testing, feeding, and giving insulin to our cat. Today after my husband tested around 1:00 pm, and got the low number of 2.0, I called the vet to ask if we should continue with 1u. She said to continue until Monday and do a curve. Mocha's insulin was reduced from 2u to 1u just this Monday, 4 days ago, based on a curve at the vet on Monday. We use a human meter, One Touch.

 

[tiffmaxee]

This info is very helpful. Based upon what you are doing I think you will want to follow SLGS but you can read about both if you look at the yellow stickies at the top of the Lantus forum page. Around here we generally move up and down in .25 increments but I think your cat was probably started on too high a dose. Cats usually test higher at the vet's office due to stress but we have had a few test lower. It's much more accurate to test at home. The only curve ever done by my vet was after the very first shot Max got. But you have to do what makes you comfortable. I also found several small meals worked best for Max and tried to stop all food by the second half of the cycle but every cat is different. You will soon find out what works for Mocha.

BTW one of my two I got after losing Max is named Mocha too. She's part Siamese. The rescue named her and I thought about changing their names but never found any that worked better for Chai so kept the names. Your Mocha is beautiful.

If you add the info about the meter, dx date, other medical issues, food, to your signature people won't keep asking you.

Oh my! I just saw that test of 36. That is too low. With SLGS you reduce with anything under 90 and with TR the reduction number is under 50. Please lower the dose to .75. If you feel it necessary please call your vet with this information. Some cats will be hypo with that low a number. I hope you gave some high carb food or karo. If you haven't please feed her and test again. High numbers won't kill but I hypo can send her to the ER and can kill.

After you check in with your vet please read the stickie on handling low numbers.

@ShaunaG PLEASE READ NOW!

 

[Wendy&Neko]

Today after my husband tested around 1:00 pm, and got the low number of 2.0, I called the vet to ask if we should continue with 1u. She said to continue until Monday and do a curve.

Your vet is wrong. 2.0 in US numbers is 36 which is too low. Please give your kitty some syrup or honey or other high carb food. She needs to come up above 50. That 36 means the dose is too high should be reduced to at least 0.75 units.

 

[Sienne and Gabby (GA)]

Most of us are in the US and use the "other" system. It's fine since you're using the World spreadsheet.

Wendy is absolutely correct a 2/36 is too low of a blood glucose (BG) levels. Please give Mocha something to raise her BG numbers -- preferably something with high carbs (a gravy based food or add some syrup -- corn or maple syrup, honey, etc. to her low carb food).

If you follow TR, you don't want numbers to drop much below 50 and with SLGS, below 90. Those are the cut-offs for a dose reduction. I agree with Wendy -- you should reduce the dose to at most, 0.75u. Chances are that Mocha's numbers will skyrocket this evening due to dropping to 38.

 

[ShaunaG]

Your vet is wrong. 2.0 in US numbers is 36 which is too low. Please give your kitty some syrup or honey or other high carb food. She needs to come up above 50. That 36 means the dose is too high should be reduced to at least 0.75 units.

Thank you, we tested similar numbers today. I will feed her some food with gravy, and test her again in a few hours.

 

[ShaunaG]

Most of us are in the US and use the "other" system. It's fine since you're using the World spreadsheet.

Wendy is absolutely correct a 2/36 is too low of a blood glucose (BG) levels. Please give Mocha something to raise her BG numbers -- preferably something with high carbs (a gravy based food or add some syrup -- corn or maple syrup, honey, etc. to her low carb food).

If you follow TR, you don't want numbers to drop much below 50 and with SLGS, below 90. Those are the cut-offs for a dose reduction. I agree with Wendy -- you should reduce the dose to at most, 0.75u. Chances are that Mocha's numbers will skyrocket this evening due to dropping to 38.

Thank you for your comments, we will feed her food with gravy when her numbers get that low, such as today again.

 

[ShaunaG]

This info is very helpful. Based upon what you are doing I think you will want to follow SLGS but you can read about both if you look at the yellow stickies at the top of the Lantus forum page. Around here we generally move up and down in .25 increments but I think your cat was probably started on too high a dose. Cats usually test higher at the vet's office due to stress but we have had a few test lower. It's much more accurate to test at home. The only curve ever done by my vet was after the very first shot Max got. But you have to do what makes you comfortable. I also found several small meals worked best for Max and tried to stop all food by the second half of the cycle but every cat is different. You will soon find out what works for Mocha.

BTW one of my two I got after losing Max is named Mocha too. She's part Siamese. The rescue named her and I thought about changing their names but never found any that worked better for Chai so kept the names. Your Mocha is beautiful.

If you add the info about the meter, dx date, other medical issues, food, to your signature people won't keep asking you.

Oh my! I just saw that test of 36. That is too low. With SLGS you reduce with anything under 90 and with TR the reduction number is under 50. Please lower the dose to .75. If you feel it necessary please call your vet with this information. Some cats will be hypo with that low a number. I hope you gave some high carb food or karo. If you haven't please feed her and test again. High numbers won't kill but I hypo can send her to the ER and can kill.

After you check in with your vet please read the stickie on handling low numbers.

@ShaunaG PLEASE READ NOW!

Thank you, I will read the items you suggest on the stickies. I appreciate your input, and I will update my spreadsheet with Mocha's info very shortly....

 

[tiffmaxee]

Please test again 20 minutes after feeding. Did younreduce the dose? BG in the 30’s is dangerous. If you haven’t reduced call a vet or ER and tell them the numbers you are getting. Some will have you bring the cat in for an IV drip. Normal BG is 50-120.

 

[Chris & China (GA)]

I will feed her some food with gravy, and test her again in a few hours.

PLEASE do not wait a few hours to test again!!

When they drop below 50, you should feed something high carb and test again in 30 minutes.....IF they're still above 50, test again in another 30 minutes and (if still going up) one more test an hour later.

We want to continue testing for 2 hours from the time you had to intervene with high carb food to make sure they're coming up and staying up. They can go back down!

If they drop below 50 again, that 2 hour "clock" starts over

You don't have how much you shot today in your spreadsheet...If it was 1U again, you NEED to reduce the dose. I would hope that if you called your vet, they'd tell you the same thing!....if not tell you to come in for a glucose drip!

 

[Wendy&Neko]

Please update your spreadsheet or respond to how much insulin you shot today. We are worried about your kitty. 1.0 units is way too much insulin for her. A cat's pancreas is unique, it has the ability for some of the beta cells to heal, reducing the amount of insulin a cat needs. You must lower the dose so she doesn't hypo.

Hypo symptoms and how to treat them.

 

[ShaunaG]

PLEASE do not wait a few hours to test again!!

When they drop below 50, you should feed something high carb and test again in 30 minutes.....IF they're still above 50, test again in another 30 minutes and (if still going up) one more test an hour later.

We want to continue testing for 2 hours from the time you had to intervene with high carb food to make sure they're coming up and staying up. They can go back down!

If they drop below 50 again, that 2 hour "clock" starts over

You don't have how much you shot today in your spreadsheet...If it was 1U again, you NEED to reduce the dose. I would hope that if you called your vet, they'd tell you the same thing!....if not tell you to come in for a glucose drip!

Thank you, I will reduce the dose to .75u tonight and test again after...

 

[ShaunaG]

Please update your spreadsheet or respond to how much insulin you shot today. We are worried about your kitty. 1.0 units is way too much insulin for her. A cat's pancreas is unique, it has the ability for some of the beta cells to heal, reducing the amount of insulin a cat needs. You must lower the dose so she doesn't hypo.

Hypo symptoms and how to treat them.

Thank you, I will reduce the dose to .75u tonight as recommended. I appreciate your advice.

 

[Sienne and Gabby (GA)]

Frankly, I think you could reduce the dose to 0.5u. It's much easier on the nerves to have to deal with numbers that may be a bit higher than to be chasing after low numbers and fearing symptoms of hypoglycemia.

Also, please get at least a test before you go to bed every, single night. Many cats numbers tend to drop during the PM cycle. You may be missing dose reductions and you're definitely missing half of your data. The best way to keep your cat safe is to test.

Also, please take a look at the latter part of this sticky on managing low numbers. When numbers drop, even if you feed your cat higher carb food to get the numbers back up, once the food wears off, the numbers can drop again. It takes a bit of monitoring as well as learning about how your cat responds to be sure your kitty is safe.