Hello and Welcome
You've already got the information on running curves from Chris and Amy.
this stood out to me
Others say, because lantus is a slow constant release insulin that curves are pointless.
To me that makes absolutely no sense, even though with lantus the curves, once well regulated, can be gentle and almost flat, how would you know how low the insulin is getting kitty, and I am going to use a couple of real life examples to illustrate why.
Some kitties can also see sharp drops on lantus, take a look at Jasmines spreadsheet
https://docs.google.com/spreadsheets/d/1nzQYIaPwR6ysnSB47X3Nb0UFGNaLBRTsnv_61cJHf1s
you will see an example of sharp drops on 0.75u of lantus. She is not yet well regulated. You can see that some days she is getting into low numbers 50-80 range and other days she is running high and flat numbers with no real curve.
And take a look at my Georges SS, also on 0.75u
https://docs.google.com/spreadsheets/d/1xj4rZrvIsLKB_3mWGik7YXLTiwoCKh5pNNp9vf7vlO8/edit#gid=140068872
in complete contrast, he is well regulated, and you can see how on a day to day basis his numbers are pretty flat. Additionally George's spreadsheet also illustrates how a cat's patterns can change, see how in early February, when George fell out of remission (after a steroid shot) his numbers were high with relatively no curve to speak of, then once the steroids were out of his system and we got to a good dose he started seeing sharp drops, and more prominent curves, after some time you can see his body adjusted and he leveled out on the dose giving the typical flat curve that lantus is famous for.
Another thing that becomes obvious when you look at Jasmine's numbers is how a curve run just once a week say would not necessarily give you an accurate picture of what is going on with your kitties BG. I know that a lot of vets just recommend to not test and run curves once a month or once a every couple of weeks, you can see that if kitty is not well regulated, that may give you a very skewed view on what the insulin is doing, depending on what day you happen to run a curve.
- Here we advocate daily testing above all.
- We never shoot blind, always getting a test before giving insulin,
- and most of us get at least one other test in each cycle, as a minimum.
I test a bit more, because I like to be in control of his BG and be confident in the dose I am shooting, keeping close monitoring allows me to be reasonably aggressive with the dosing strategy I follow, Tight Regulation Protocol. I am able to do this because I am at home enough of the time to be able to do it safely.
There is another approach/dosing strategy Start Low go Slow(SLGS), for those who don't feel that Tight Reuglation(TR) is a good fit, for example if CG is unable to monitor enough, or whose kitties are still eating dry (an all wet Low carb diet is a prerequisite for TR).
SLGS requires lest testing, but we still always test before insulin shot (to make sure it is safe) and most get at least one other test in both cycles, with weekly curves to assess dose and determine if they need to increase dose or hold for a further week.
Here is a link to the dosing methods we follow, it explains the procedure and what is required for each method
http://www.felinediabetes.com/FDMB/threads/dosing-methods-start-low-go-slow-slgs-tight-regulation-tr.210110/
both of them have helped many CG attain regulation and for those lucky enough even remission, in a safe and controlled fashion. Tight Regulation Protocol get's you there more quickly, though it requires more monitoring, and getting regulated quickly gives your kitty the best chance of achieving remission.
We hope that you will visit again, and we would be happy to help with any questions you may have.
