Question about doseage

Scdal

Scdal

Member Since 2020
About a week ago, my vet decided to give Phoenix the Lantus twice a day instead of once. How often should you increase the dose of insulin? I have read on the forum that it takes time for him to adjust to taking insulin and that his system will try to adjust to to the lower numbers by compensating and produce higher readings.

Phoenix's numbers have been all over the place. His lowest reading is before breakfast and is usually 150 - 280 range. Then it goes to mid 300 after 4 hours and mid 400 after 8 hours. Then it falls back to the mid 300 range in the evening. Phoenix does have a spreadsheet you can view.

My main question is how often should the dose of insulin be adjusted? He is taking 4 units in the morning and 4 units in the evening. He weighs 34 pounds & that is why the insulin units are high. Any advice would be appreciated. Thank you
 
Have you read the information on the 2 dosing methods? Start Low, Go Slow and Tight Regulation?

How often to increase depends on which one you choose.

BUT, you need to find a dose you can give consistently....Lantus dosing is always based on how LOW it takes them, not the Pre-Shot. Every time you change the dose you can get wonky numbers.
 
With the "Start low go slow" method, you stay at the same dose for at least a week. Then you look for the low point of the day and decide if you should increase. (If it's over 150 you increase the dose by .25)

His low point has been below 150, so you shouldn't increase.

I'm new to all this, but looking at your spreadsheet, he may be "bouncing." On 4-28 he was at 126 in the morning. It may have been even lower before that. His body reacts to the glucose going too low, and increases his glucose. So his numbers shoot up. How late can you test him at night? Can you get up a few hours early one morning to test him? He may be going down so low that you need to decrease his shot.

Hopefully someone with experience will look at your spreadsheet, and have some advice. I'm really impressed with how often you test him, you are really doing a good job. It just takes time to get the right dose.
 
SingsToCats said:
With the "Start low go slow" method, you stay at the same dose for at least a week. Then you look for the low point of the day and decide if you should increase. (If it's over 150 you increase the dose by .25)

His low point has been below 150, so you shouldn't increase.

I'm new to all this, but looking at your spreadsheet, he may be "bouncing." On 4-28 he was at 126 in the morning. It may have been even lower before that. His body reacts to the glucose going too low, and increases his glucose. So his numbers shoot up. How late can you test him at night? Can you get up a few hours early one morning to test him? He may be going down so low that you need to decrease his shot.

Hopefully someone with experience will look at your spreadsheet, and have some advice. I'm really impressed with how often you test him, you are really doing a good job. It just takes time to get the right dose.
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Thank you for responding. I usually give him his second injection at 9pm. I set my alarm for 11:30 to check his glucose. I will do what you suggest and get up early one morning to see if his glucose is lower.
I do think he might be bouncing though I am new to this and don't know much. My vet said not to increase his dose this week which goes along with what you said.
I have been very apprehensive about following advise on a forum instead of a vet. But the more I learn, the more I rely on advice from this forum. You all do seem to be more informed. Thank you for your help.
 
You're welcome. Next time you post you might put ? at the beginning of your post, and ask about bouncing. (Hover over "No prefix" and select ?)

What did your vet think about his numbers?

I listen to my vet, but I also listen to people here. There's a lot of experience on this message board, and that makes a difference.
 
Scdal said:
He is taking 4 units in the morning and 4 units in the evening. He weighs 34 pounds & that is why the insulin units are high
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If you are following Tight Regulation for dosing, then the starting dose is based on weight, but other than that, there is little correlation between dose and cat's weight. For example, my girl was around 14 lbs (plus or minus a pound), and the good dose for her varied from 8.75 units to 0.25 units. She had a couple concurrent conditions that impact her blood sugars but gives you an example that the dose didn't relate to her weight which didn't vary much. We also have large cats on small doses, and small cats on larger doses.

Has Phoenix always been on raw food? Just curious if there has been a food change.

If you were following Tight Regulation Protocol for dosing you can increase after three days by 0.25 units if all you are seeing is nadirs over 200, which is what you are currently seeing. SLGS would have you hold the dose a couple more days. Read over the dosing methods sticky notes, and if you decide one or the other is better for your lifestyle, then put either TR or SLGS in your signature so we can help you better.
 
Thank you and sorry it has taken me so long to respond. I had some family matters that came up. Yes, Phoenix has always been fed a raw diet. I did have a small ball that I filled with Purina cat chow. I only gave this to him when I was going out for the day. It kept him entertained while I was gone rolling it across the floor to get the treats. My vet said that this shouldn't have been enough to cause a problem.

I have been emailing my spreadsheet to the vet each week. He told me today to increase from 4 units twice a day to 5 units twice a day. It always scares me to increase the dose but his numbers are high enough that he should be okay.

Let me know what you think. At first I was hesitant to rely on your advice over my vet. But I do think that the people on this website are better informed. Being new to the forum, I was scared to take the advice of strangers over my vet.
 
The folks on this website saved my girl's life.

Since you saw a number in the low blues on this dose, we would have you increase to 4.25 units. Up to 5 units is too big a jump.
 
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