? Can't find a dosage that works

[Chris & Lucy]

I'm posting to try and get some input into what I should try next. Last year when we first started this journey Lucy got regulated fairly quickly and stayed that way until fall(time change). Through the winter, even though her numbers were high, she didn't have any clinical signs. In the spring(time change) she appeared to be ready to get back to some good numbers. I couldn't never really get her steady and then she needed a dental and some teeth pulled. I figured this may be the problem getting her numbers steady but after the dental and a couple rounds of antibiotics I just can't find a dose that's going to consistently give her good numbers. I'll get a day of better numbers, but I can't duplicate it. We've been up and down the dosing chart several times and I just can't seem to find the right dose. As I raise her dose I get more and more nervous that I missed something along the way and I'm giving her too much insulin.

Any extra eyes that could spot something in her SS or suggest something would be appreciated.

 

[JeffJ]

I would really recommend pre-tests for AMPS and PMPS. Not sure why you are not doing that. It is especially important if your kitteh is oscillating. The hypo on April 29th may have been avoided by doing an AMPS test. Without a regular pattern to look at, it is harder to make recommendations.

For the oscillations, some cats just oscillate. Leo is one of them. Part of his oscillations are from prednisolone and Acromegaly. However, other kittehs oscillate for different reasons. With Leo, I evaluate the oscillations daily and adjust based on that. But that is not consistent with the 2 dosing protocols that are linked to this forum.

 

[Wendy&Neko]

I recommend selecting one of the two dosing methods used here, Tight Regulation Protocol or Start Low Go Slow. Then follow the dosing guidelines contained in them. They each suggest getting a test before each shot. I would also get some night time tests, as many cats go lower at night. We determine how to dose based on low points, which are typically mid cycle on Lantus. And finally, a cat's dose requirements can change over time. That's one of the reasons to test and have a dosing method to follow.

 

[Chris & Lucy]

I would really recommend pre-tests for AMPS and PMPS. Not sure why you are not doing that. It is especially important if your kitteh is oscillating. The hypo on April 29th may have been avoided by doing an AMPS test. Without a regular pattern to look at, it is harder to make recommendations.

For the oscillations, some cats just oscillate. Leo is one of them. Part of his oscillations are from prednisolone and Acromegaly. However, other kittehs oscillate for different reasons. With Leo, I evaluate the oscillations daily and adjust based on that. But that is not consistent with the 2 dosing protocols that are linked to this forum.

Thanks. I'll try to get more PS numbers. Her PS are usually in the 300's. Her oscillations are usually between 200-300 at Nadir. She occasionally goes down into the 100's but when I hold the dose I can't get a repeat of those numbers.

 

[Chris & Lucy]

I recommend selecting one of the two dosing methods used here, Tight Regulation Protocol or Start Low Go Slow. Then follow the dosing guidelines contained in them. They each suggest getting a test before each shot. I would also get some night time tests, as many cats go lower at night. We determine how to dose based on low points, which are typically mid cycle on Lantus. And finally, a cat's dose requirements can change over time. That's one of the reasons to test and have a dosing method to follow.

I try to follow the SLGS method. Might be a little impatient with holding the dose but I usually give it at least 6 cycles. I do get plenty of tests ranging from +3-+7. And try to adjust based on that lowest number in the cycle. I just can't seem to break into the lower numbers.

 

[Wendy&Neko]

Could you put SLGS in your signature? That'll help us help you.

Any chance of getting a test before bed at night? So many people get surprised by what they see, me included.

 

[Chris & Lucy]

Could you put SLGS in your signature? That'll help us help you.

Any chance of getting a test before bed at night? So many people get surprised by what they see, me included.

I will reread the protocol and if it looks like I am following it close enough I will add it to my signature.

Would it do any good to get a +2 at night? My understanding and experience is that Lantus takes about 4 hours to 'kick in'.

 

[Shawna & Davidson (GA)]

I will reread the protocol and if it looks like I am following it close enough I will add it to my signature.

Would it do any good to get a +2 at night? My understanding and experience is that Lantus takes about 4 hours to 'kick in'.

Remember ECID and with Davidson the Lantus kicks in at +3.........the more tests, the merrier! Good luck!