11/11 Gus - New to Lantus forum, starting SLGS protocol

Gus the Furminator

Gus the Furminator

Member Since 2021
Hello all!

I’ve made a few posts to the main forum, but I’m moving in here now :)

I’ve just spoke with my vet and he’s on board with me trying out SLGS protocol, yay! Finally! He was ok with me doing TR as well, I’m just not as comfortable with that at the moment.

Gus is currently on 2 units of Lantus. His numbers typically range from 10-15 (180-270) throughout the day. I keep my spreadsheet up-to-date most of the time. Link in signature.

I’ve been trying to get at least 4 tests a day, two preshot and 1 mid cycle for each. This week is a little wonky - we are doing Reno’s on the bathroom (of course this is our safe place/test spot) but he’s doing ok with the kitchen for now - he wanders a bit more but we get it done in time.

I want to start this ASAP! Looking for some guidance and any tips or suggestions you may have before I get started (there are 5hours before Gus next shot)

Checking to see if I have this right…
I will only increase by .25u (new dose would be 2.25u) for the next week, then perform a curve at the end of the week… of course I’ll check in if anything goes wonky with his numbers. I think it’s that simple.. right?

Please let me know if I’m in this forum too early or if my title in not helpful for you.

Let me know if you need anymore information from me!

TIA.
 
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Welcome!
I am no expert but looks to me like you have things under control!
Well done
You are in the right place.
Someone will be along shortly to answer your questions.
You can edit your title by adding the question mark icon at the beginning of your title itself.
This will attract attention.
When questions are answered, remove the question mark.
Hugs
 
Many thanks for your guidance on the title and for letting me know I’m on the right track for SLGS…

I’m not too concerned at this point with - .25 increase tonight. Was just wanting to introduce us here and absorb any feedback or suggestions. :)

I’m excited to get things moving :)

*hugs back*
 
Gus the Furminator said:
Many thanks for your guidance on the title and for letting me know I’m on the right track for SLGS…

I’m not too concerned at this point with - .25 increase tonight. Was just wanting to introduce us here and absorb any feedback or suggestions. :)

I’m excited to get things moving :)

*hugs back*
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This is an AMAZING resource.
You know where you see a box that says prefix when you press edit title?
If you tap that it will show some options and select the question mark.
Just draws attention better than putting it in the main title.
Another option is 911 which shows up red on the board and gets a rapid reaction for emergencies!
I had to use it this morning actually, and my goodness, the soldiers showed up at the gates immediately haha.
My kitty is ok now.
I will tag someone here so that one of the experts is sure to see you.
@Suzanne & Darcy
 
Cindy loves Tansi said:
This is an AMAZING resource.
You know where you see a box that says prefix when you press edit title?
If you tap that it will show some options and select the question mark.
Just draws attention better than putting it in the main title.
Another option is 911 which shows up red on the board and gets a rapid reaction for emergencies!
I had to use it this morning actually, and my goodness, the soldiers showed up at the gates immediately haha.
My kitty is ok now.
I will tag someone here so that one of the experts is sure to see you.
@Suzanne & Darcy
Click to expand...

I was wondering how to get that, fixed :) Thx!

Oh boy! Happy to hear your kitty is doing better now, thank goodness for this group of knowledgeable people!
 
FrostD said:
He's seeing some nice blues in there! I'd feel a little better if you could get a curve in before increasing, just to make sure he's not dipping lower than what you're catching. But yes, when and how much to increase depends on nadir.
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I LOVE seeing that blue <3. Just not getting any consistency (onset/nadir wise), which drives me bananas, I know this comes with time though.

His meals are the same 4 flavours a day and I try my hardest to keep to a schedule... insulin time, +3, +6, +9 in the AM cycle. Then PM insulin, he might get a +2, +4 and +6... sometimes I get up in the early am +9 to avoid him being too hungry and vomiting but it depends what time he gets the last meal before I go to bed. Note: It sounds like a lot but he's getting large meals at insulin and 1/4 can for snacks along the way... equaling about 4 cans of FF a day. BUT still no consistency...

Hmm. I hadn't thought of doing a curve first... good point. Shucks... I really wanted to get this going since it's been awhile on this dose with no big changes. We're also doing some reno's around the house this week/weekend... tougher to remember to test (my phone it's always with me for alarm - dust). I will try to get a curve done tomorrow in the AM cycle...
 
Gus the Furminator said:
tougher to remember to test (my phone it's always with me for alarm -
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Lots of us use our phones to remind us to test. Life gets busy and it's easy to lose track of time so having that alarm on your phone is a great way to remind you it's time to test!

Most of your tests have been in the last half of the cycle...You might want to try to get some earlier in the cycle too so you see when his onset is as well as finding about when he usually nadirs.

You have been on the 2U dose too long though. Any chance you can get a curve in tomorrow or would it have to wait for the weekend?
 
Chris & China (GA) said:
Lots of us use our phones to remind us to test. Life gets busy and it's easy to lose track of time so having that alarm on your phone is a great way to remind you it's time to test!

Most of your tests have been in the last half of the cycle...You might want to try to get some earlier in the cycle too so you see when his onset is as well as finding about when he usually nadirs.

You have been on the 2U dose too long though. Any chance you can get a curve in tomorrow or would it have to wait for the weekend?
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Lol, last person I talked with told me I should/needed to get some test done later in the cycle.. so that what I’ve been trying for.

I generally will set my alarm but with Reno’s happening and not carrying my phone with me, I might miss something! BUT I’m going to try it tomorrow for sure, I want to start this ASAP!

if it doesn’t happen tomorrow, what do you suggest? I’m definitely going to try my hardest to do it and be on time tomorrow though!
 
I'm sorry I should have explained my thought process - I think you have room for an increase, but those blues combined with not much data between +3 and +6 ish, I just want to make sure he's not dipping into green. It's unlikely, but you never know. Even if you can catch just the first 6 hours that would be helpful.
 
I agree that it looks like Gus needs more insulin. I also agree that he’s been on this dose too long. You don’t want him to get too cozy in these yellows. Also definitely try to get some earlier tests to add to your data. Curve is a great idea. Have you read through the SLGS protocol information yet? Question: why did you increase from one two units? Was that just a vet suggestion? That is not a criticism, by the way.
 
Suzanne & Darcy said:
I agree that it looks like Gus needs more insulin. I also agree that he’s been on this dose too long. You don’t want him to get too cozy in these yellows. Also definitely try to get some earlier tests to add to your data. Curve is a great idea. Have you read through the SLGS protocol information yet? Question: why did you increase from one two units? Was that just a vet suggestion? That is not a criticism, by the way.
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I have read through the SLGS protocol info, but I might go back and refresh my memory. I believe the main aspect of it is upping by .25u for a week, spot testing and curve at the end of the week, nadirs will determine if dosing is good and spot test will help me throughout the week to make sure he’s not dropping too low. Please let me know if I’m missing anything.

I like the idea of a curve tomorrow so I’m going to be diligent and try my hardest to check the clock and I just had a thought, I’ll put my phone in a baggie to avoid dust and debris (we’re doing Reno’s ourselves).

And yes, increase from 1u to 2u was based on vet suggestion.
 
FrostD said:
I'm sorry I should have explained my thought process - I think you have room for an increase, but those blues combined with not much data between +3 and +6 ish, I just want to make sure he's not dipping into green. It's unlikely, but you never know. Even if you can catch just the first 6 hours that would be helpful.
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No worries, I love the idea of doing a curve, I hadn’t thought of that.
 
Gus the Furminator said:
I have read through the SLGS protocol info, but I might go back and refresh my memory. I believe the main aspect of it is upping by .25u for a week, spot testing and curve at the end of the week, nadirs will determine if dosing is good and spot test will help me throughout the week to make sure he’s not dropping too low. Please let me know if I’m missing anything.

I like the idea of a curve tomorrow so I’m going to be diligent and try my hardest to check the clock and I just had a thought, I’ll put my phone in a baggie to avoid dust and debris (we’re doing Reno’s ourselves).

And yes, increase from 1u to 2u was based on vet suggestion.
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You will do really well! I can tell!
 
Suzanne & Darcy said:
You will do really well! I can tell!
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Thanks! I’m really excited to get started.

When @Chris & China (GA) told me I was holding doses too long, I started to worry.

That said, I have a really great relationship with my Vet and want to run it by him… Even though you all live for helping diabetic kittys - and if I’m being real, you all probably know more about the disease - I think I might now too(so much reading!). He’s better than most vets, I hear about so many terrible vets giving advice… he’s really knowledgeable, a cat expert AND a travelling vet! He was really happy to hear how much knowledge I’d gained, was very open to trying these dosing methods and listening to my opinions. Long story short, he can’t help me if he doesn’t know what I’m doing with Gus… so it’s taken a bit longer than I’d have liked to talk but we’re here now! Yay!
 
FrostD said:
Yes I would say you're good for a 0.25U increase!
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Thank you!

I was a bit worried that the Reno’s and loud noises would be stressful on him.. not sure if that’s what influenced his pink number last night but he looked pretty chill for the most part. This morning/afternoon has been a quiet morning - so it turned out to be a good day for a curve!

ok, wish us luck!
 
Gus the Furminator said:
ok, wish us luck!
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Good luck! Don't be surprised if the numbers actually go up when you increase though. We don't know why it happens but it happens often enough that we have a name for it! NDW (New Dose Wonkiness).

I did say you were holding the dose too long because if you're not getting the numbers you want in 7 days, it's time to go up. If you hold it too long, glucose toxicity can set in which basically means that the body gets used to being high even with the insulin. Once glucose toxicity sets in, you may have to go higher in dose to "break through" it than you would have if you hadn't held the dose too long. (I hope that made sense).

Can we also ask you to start a new thread every morning? Here in the Lantus forum, we usually do start a new thread every day for each cat with the subject line formatted like:

Date, Cat's name, AMPS ###......Then as the day goes on, if you get more tests in, you "edit" your subject line to add the extra info....so maybe something like:

11/12, Gus, AMPS 277,+2 290,+4 211,+6 265,+8 284,+10 272, PMPS ###

If you run out of room, you can go back and remove some of the numbers so you can get the PMPS numbers in (but you're not going to test all night...usually...lol)

By doing it like that, the people who scan the forum can easily see how each cat is doing that day and if they see something that concerns them, they will comment on that thread. First we look for 911's (medical emergencies only), then any threads with ? prefixes (which indicate there's a question in the post) and then any threads with subject lines that catch our eyes (like if we saw AMPS 272, +2 134, we'd hop on there to make sure the caretaker knows to get more tests in because that's a huge drop for so early in the cycle).

Don't freak out about it though. You're doing great and hopefully Gus will start to respond better to treatment soon! It's great that you have a good relationship with your vet too! That's very special!
 
Good to know about the NDW! Could have been discouraging.

I’m glad you brought the glucose toxicity up to me (a few times once near the end of his 1u dose and once again on 2u). I wish I had acted sooner. Fingerscrossed that we don’t have to break through that barrier - we’re on a good path now though, at least.

Well noted on the titles (thanks for giving me an example). I knew there was a reason for that format, and you’ve explained it well!! I will start a new thread each day… starting tomorrow ;)

Just one question. Ive just given Gus his increased dose. I’m definitely going to test again this evening. If you were me and by looking at Gus’ SS, when do you think would be a good time? I thinking +4 and see how he’s doing? Test again before bed unless +4 is lower than expected?

Since we did a curve today, We’ve done many pokes, hoping to give him a break but honestly want to see how the new dose is taking effect as well.
 
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Gus the Furminator said:
I generally go to bed around +7, +8, I’m a bit of a nighthawk
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That's great then!

A lot of times, the +2 can almost predict how the rest of the cycle is going to go (some cats the +3 is more predictive)

If the +2 is about the same as the PS, it's usually a pretty normal cycle....gradually down to nadir and gradually back up to the next PS

If the +2 is higher than the PS, it could be the sign of a bounce starting and those are the cycle where it's usually OK to take a pokey break and catch up on some sleep

If the +2 is lower than the PS, that's your "early warning" that kitty might be going a lot lower later in the cycle and those times you really need to plan on getting more tests later in the cycle.
 
Chris & China (GA) said:
That's great then!

A lot of times, the +2 can almost predict how the rest of the cycle is going to go (some cats the +3 is more predictive)

If the +2 is about the same as the PS, it's usually a pretty normal cycle....gradually down to nadir and gradually back up to the next PS

If the +2 is higher than the PS, it could be the sign of a bounce starting and those are the cycle where it's usually OK to take a pokey break and catch up on some sleep

If the +2 is lower than the PS, that's your "early warning" that kitty might be going a lot lower later in the cycle and those times you really need to plan on getting more tests later in the cycle.
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Great info! I’ll screenshot that and add it to my collection.

I ended up going with a +4 tonight and he was at 279, his PS was 283… I might take one more before bed… his nadirs are all over the place… I can’t seem to make any sense of it, tbh

Many of his lowest numbers are at PS, +4 is the next most common.. I hope that will soon become a little more consistent - but guessing that comes with regulating and time!?
 
As Chris mentioned, for many cats on Lantus the +2 relative to the preshot is often a good indication of what the kitty will be doing that cycle. With the +4 being about the same as PMPS I'd say you can call it a night, but if you are so inclined to test once more before bed...well you sure can, since all data is good data :)
 
Christie & Maverick said:
As Chris mentioned, for many cats on Lantus the +2 relative to the preshot is often a good indication of what the kitty will be doing that cycle. With the +4 being about the same as PMPS I'd say you can call it a night, but if you are so inclined to test once more before bed...well you sure can, since all data is good data :)
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Thank you! Maybe I’ll give Gus the option ;) He’s been poked a lot today.
 
Christie & Maverick said:
With the +4 being about the same as PMPS I'd say you can call it a night, but if you are so inclined to test once more before bed...well you sure can, since all data is good data
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I agree with Christie! With such a stable number at +4, he's not diving...just leisurely back-stroking around the pond.

Take advantage of cycle's like this and get some extra snooze time in and give the ears a pokey break. Trust me, you're going to have plenty of nights when you'll need to stay up late and test a lot more!
 
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