Time to Switch?

[Darwin H.]

Have not made a lot of progress with Basaglar use for 2.5 months with Simbas numbers but have greatly reduced his urination problem and even got his leg strength back so that he can jump up on the bed rather than pull himself up. Is this as good as it gets? He looks fine and act well. I wonder if that is enough or chance starting with a new form of Insulin?

The Vet has recommend to soon switch types to Vetsulin or Novalin N. What say the voices of experience here? *Of course with the snow storm coming I went out and purchased a new pen of Basaglar - good until March of 2020 that sits unopened in my refrigerator... LOL!!!

I wonder if I should just stay with the Basaglar and adjust his dosage as needed? Or Possibly give it more time to work in his system for 2-3 more months. Thanks for all the caring voices that have gotten me this far.

 

[Chris & China (GA)]

Switching to Vetsulin or Novolin would be the last thing you'd want to do. Basaglar is a good insulin for cats, but you're not really using it correctly.

Glargine needs consistency. You don't change the dose based on the Pre-shot numbers. Dosing is always based on the nadir....the lowest point in the cycle.

When Simba dropped under 90 (on 1/30, 2/5 and 2/10) you should have reduced the dose down by .25 to 1.75. You'll need syringes with half unit markings to do that and you have to eyeball the dose since there's no line there.

Then you hold the dose for 7 days (on SLGS)

You need to be getting tests on the PM cycle. At least a "before bed" test to make sure he stays safe overnight. Most cats go lower at night, so it's really important. Also, without tests on the PM cycle, you're missing half the data.

It looks to me like Simba may be overdosed.....he drops too low and then bounces high, but you're not getting enough tests in to know for sure.

I'd like to see what happens if you drop back to 1.5 and get a few more tests in. The bad thing about SLGS is that doing a curve only once a week may not catch the important numbers we need to see.

 

[tiffmaxee]

Many cats drop at night. It would help to know if you get some before bed tests at +3-6 if possible.

 

[Darwin H.]

OK, I will get to testing before bedtime starting tonight. I thought the mid day testing was more important? SO you are saying do both mid test day and night? I know they are all important. I have syringes with the half markings visible so no problem with that. Chris - His worse numbers came from 1.5 so I don't understand why you think that is good to go back to? I was thinking he might need more not less since he has not been consist in the 200's? Thanks.
I'll stay on the Glargine. . .
** I tried to test my 17 year old feral, now domesticated, cat Oscar this morning and he was having none of that nonsense that Simba puts up with.. LOL

 

[Chris & China (GA)]

His worse numbers came from 1.5 so I don't understand why you think that is good to go back to?

Because at 2U he dropped into the 50's.....so if you're doing SLGS, he earned a reduction down to 1.75

If you've got the half unit syringes, I'd like to see how he does with 1.75 and some more testing.(I didn't know if you had them, so I suggested 1.5 since it's a little easier)

I thought the mid day testing was more important? SO you are saying do both mid test day and night?

Mid-day testing is important.....but so is getting tests on the PM cycle. Think of your spreadsheet like it's a puzzle.....if the only pieces you have filled in are on the left side of the puzzle, you have no idea what's on the right side so you aren't seeing the whole picture.

Now on the PM cycle, not many people can routinely get mid-cycle tests (especially if they have to work the next day) but getting a "before bed" test can help. If he's going down too much or too quickly, you may need to set an alarm to get more tests in.

 

[Sienne and Gabby (GA)]

I'm in complete agreement with Chris. The shorter acting insulins, such as Vetsulin, are not great for the majority of cats. The American Animal Hospital Assn recommends either glargine or Prozinc for diabetic cats in the feline diabetes guidelines.

I'd encourage you to read through the instructions for the two testing approaches we use and if you have questions about SLGS, please ask. It takes a while to really absorb the content. Regardless of the dosing method, because a dose was or wasn't good at one point in time, that generally changes over time. A dose can be too high, so your kitty earns a dose reduction; too low and you increase the dose. What wasn't good a month ago may be perfect now.

For those of us who open a spreadsheet for every condo where we make a comment, it's hard to really know what's going on with Darwin. It's important for a cat's safety to have pre-shot test data. You've done great at getting those tests. As Chris noted, glargine dosing is based on the lowest number in the cycle. If you're not getting any spot checks, you have no idea whether your dose is doing the job you want it to do. With SLGS, you need to do a curve on a weekly basis but you also need to get at minimum, one test during BOTH the AM and PM cycles. (If you work, it may be hard to do that every day. If you can't get an AM spot check, the PM numbers are doubly important. However, test when you can -- before you leave, when you come home, if you wake up at night for whatever reason, etc.) Many cats experience lower numbers at night so getting a test before you turn in for the night("before bed" test) is important -- it will tell you if Darwin is in safe numbers. Likewise, spot checks at any time let you know where numbers are heading, if you need to monitor more closely, and if you need to prop up numbers with food because numbers are dropping and it's time to reduce the dose.