Squints AMPS 106, 186+2, 101 +4, 68 +6. 73 +6.5, 68 +7, 67 +8, 76 +8.5. PMPS 163

Since you shot, you need to fill in the dose on your spreadsheet. If there's no amount in the "U" column, it's assumed you skipped (or we'll pester you by asking).

I've got a question. What numbers are you basing your dosing on? It looks like you're using the pre-shot numbers. If that's the case, Lantus dosing is based on the lowest number in the cycle. I'm asking since it looks like you increased by 0.5u on 10/12. While you've been seeing some high numbers, you were also seeing nadirs that were under 300. Those high numbers are the result of Squints bouncing. The low numbers sent his liver and pancreas into panic mode. They released a stored form of glucose along with counterregulatory hormones that cause the numbers to spike upward. The more time that Squints spends in normal range numbers, the less the bouncing. It's annoying but a normal part of the process.

If you are unsure whether it's safe to shoot, don't feed your cat. You don't want the pre-shot number to be influenced by food. It's the same reasoning as holding all food for the 2 hours prior to shot time. In this regard, TR and SLGS are the same. Ultimately, you want to be able to shoot low numbers.

Since you're beginning to see nadirs that are below 200, you want to hold the dose no more than 5 days. At that point, you evaluate the dose and if indicated, increase.
Increasing the dose:
  • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
    • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
    • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
  • Increase by 0.25 unit after 3 days (6 consecutive cycles) if nadirs are greater than 200, but less than 300.
  • Increase by 0.5 unit after 3 days (6 consecutive cycles) if nadirs are greater than 300.
Click to expand...
 
Sienne and Gabby (GA) said:
Since you shot, you need to fill in the dose on your spreadsheet. If there's no amount in the "U" column, it's assumed you skipped (or we'll pester you by asking).

I've got a question. What numbers are you basing your dosing on? It looks like you're using the pre-shot numbers. If that's the case, Lantus dosing is based on the lowest number in the cycle. I'm asking since it looks like you increased by 0.5u on 10/12. While you've been seeing some high numbers, you were also seeing nadirs that were under 300. Those high numbers are the result of Squints bouncing. The low numbers sent his liver and pancreas into panic mode. They released a stored form of glucose along with counterregulatory hormones that cause the numbers to spike upward. The more time that Squints spends in normal range numbers, the less the bouncing. It's annoying but a normal part of the process.

If you are unsure whether it's safe to shoot, don't feed your cat. You don't want the pre-shot number to be influenced by food. It's the same reasoning as holding all food for the 2 hours prior to shot time. In this regard, TR and SLGS are the same. Ultimately, you want to be able to shoot low numbers.

Since you're beginning to see nadirs that are below 200, you want to hold the dose no more than 5 days. At that point, you evaluate the dose and if indicated, increase.
Click to expand...

Determining what amount to shoot is confusing...
This post I did has discussion on the increase to 1.75
https://felinediabetes.com/FDMB/posts/2864172/

So, if I'm supposed to asjust, thats what I need to figure out. I have all the instructions for TR... i printed them out so I can read them and make sense of it all.
 
Thanks for the link. I can see Elise's point. I think it's a judgement call. The numbers around that time were high. For me, I would have liked to have seen some PM tests on the days that were missing readings. Squints likes to see lower numbers at night so getting at least a "before bed" test may need to be a part of your routine. At this point, the increase looks like it did the job and you're seeing better numbers. It's been 11 cycles at the 1.75u dose. You need to consider an increase of 0.25u.
 
Sienne and Gabby (GA) said:
Thanks for the link. I can see Elise's point. I think it's a judgement call. The numbers around that time were high. For me, I would have liked to have seen some PM tests on the days that were missing readings. Squints likes to see lower numbers at night so getting at least a "before bed" test may need to be a part of your routine. At this point, the increase looks like it did the job and you're seeing better numbers. It's been 11 cycles at the 1.75u dose. You need to consider an increase of 0.25u.
Click to expand...

Ok. I can do testing before bed.

Should I start 2 units tomorrow monring ?
 
StephanieNJ said:
Now at 68 +6
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Ok check again in 30 mins please, beautiful cycle. If he's in the 50s give a little low carb food, 1-2 tsp. Below 50 give 1-2 tsp medium carb. I may not be around but will do my best.

Note this only applies for this particular cycle; he should be coming up on nadir soon so we don't want to give too many carbs. We're trying to "steer" him so he stays above 50 and hangs out in green as long as possible. Feeding after nadir as insulin is wearing off will send them higher.

When you get a chance can you please add your meter to your signature? Easier for us to see it at quick glance (that 68 on a pet meter would have been different guidance).
 
FrostD said:
Ok check again in 30 mins please, beautiful cycle. If he's in the 50s give a little low carb food, 1-2 tsp. Below 50 give 1-2 tsp medium carb. I may not be around but will do my best.

Note this only applies for this particular cycle; he should be coming up on nadir soon so we don't want to give too many carbs. We're trying to "steer" him so he stays above 50 and hangs out in green as long as possible. Feeding after nadir as insulin is wearing off will send them higher.

When you get a chance can you please add your meter to your signature? Easier for us to see it at quick glance (that 68 on a pet meter would have been different guidance).
Click to expand...

Meter used upsated on signature. I will check sugar again at noon EST...
 
FrostD said:
Ok check again in 30 mins please, beautiful cycle. If he's in the 50s give a little low carb food, 1-2 tsp. Below 50 give 1-2 tsp medium carb. I may not be around but will do my best.

Note this only applies for this particular cycle; he should be coming up on nadir soon so we don't want to give too many carbs. We're trying to "steer" him so he stays above 50 and hangs out in green as long as possible. Feeding after nadir as insulin is wearing off will send them higher.

When you get a chance can you please add your meter to your signature? Easier for us to see it at quick glance (that 68 on a pet meter would have been different guidance).
Click to expand...

73 at +6.5. It came up a little
 
Perfect. Check again in 30 mins, if flat or rising should be good to go. I'd do one check 1 hour after your next one just to make sure (so 1.5 hr from now).
 
You want to make sure he stays up without food. He’s nice and flat so he should.This was a really good cycle. At this point I would not increase. See what happens tonight though.
 
I would give him a little if he hasn't eaten in awhile, since youd have to pull any food in an hour anyway.

I'll let Elise weigh in on dose
 
You were able to get some good data today, looks like Squints had some nice time in healing numbers :D. I would think since numbers are trending up you would be fine to shoot now, and you have shot similar (and lower) numbers.
 
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