Spreadsheet in signature - advice welcome!

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Brittany B

Member Since 2022
Hi All - we have done a spreadsheet for Joey from the beginning of September. We haven't been able to get his blood glucose regulated (numbers are quite inconsistent day to day and week to week lately). We stick very consistently to his food and insulin times.
We brought him to a well-known vet hospital in Canada and they ran many tests and scans to see if there was an underlying condition causing Joey to not respond to insulin consistently - nothing was identified.
We would welcome thoughts on insulin (amount/type), food, and other ideas as we would love nothing more than our boy to become more regulated.

Appreciate any help!

Thanks,
Brittany
 
Hi Brittany have you looked at the 2 dosing methods to follow when using lantus?
They will tell you when an increase or decrease is due
That 2.2 you got @+5 on 9-12 during the day cycle you should have reduced the dose by 0.25 units
We don't adjust the dose by the Pre Shots ,we adjust them by how low he's dropping
I'll tag a few members to take a look at your spreadsheet
By the way can you add a tab for the US BG numbers we need to see thst if you don't know how to do it
I'll tag Bhooma
@Bandit's Mom and she can help

@tiffmaxee

@Suzanne & Darcy

@Wendy&Neko

@Sienne and Gabby (GA)

Here is the link so you can read about lantus especially the 2 dosing methods for you to choose one and add it to your signature and spreadsheet up top

We also don't increase or decrease by 0.5 units we adjust the dose by 0.25 units at a time
Do you have the U-100 syringes with half unit markings ,they make it easier to adjust by 0.25 units
49823063143_3437e9e997_o.jpg
 
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Syringes from Canada going to tag Wendy
@Wendy&Neko to double check I gave you the correct information
Check out your local pharmacy for the BD Ultrafine II syringes (purple and yellow box). Those are U100 syringes. If you have a Costco near you, check them out. Or Safeway pharmacy
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Hi Brittany have you looked at the 2 dosing methods to follow when using lantus?
They will tell you when an increase or decrease is due
That 2.2 you got @+5 on 9-12 during the day cycle you should have reduced the dose by 0.25 units
We don't adjust the dose by the Pre Shots ,we adjust them by how low he's dropping
I'll tag a few members to take a look at your spreadsheet
By the way can you add a tab for the US BG numbers we need to see thst if you don't know how to do it
I'll tag Bhooma
@Bandit's Mom and she can help

@tiffmaxee

@Suzanne & Darcy

@Wendy&Neko

@Sienne and Gabby (GA)

Here is the link so you can read about lantus especially the 2 dosing methods for you to choose one and add it to your signature and spreadsheet up top

We also don't increase or decrease by 0.5 units we adjust the dose by 0.25 units at a time
Do you have the U-100 syringes with half unit markings ,they make it easier to adjust by 0.25 units
49823063143_3437e9e997_o.jpg
Thanks for this information, we will do the SLGS approach since it's closer to what we've been doing to date but will follow the guidelines noted. To date we have solely been changing insulin doses based on discussion with our vet.

Should we start at the same dose we're currently giving Joey or start at a lower dose since we are "officially" starting SLGS?
 
Stick to your current dose. Starting over won't be terribly effective. However, you could increase the dose to 2.75u. We increase in increments of 0.25u.

I'm tagging one of our spreadsheet gurus - Bhooma (@Bandit's Mom). The spreadsheet is fine. However, you're using the template that is only for mmol/L. The World template had a second tab that will convert your numbers to the system that we use in the US. Most of us are in the US and it's a bit laborious to manually multiply all of your data by 18 to convert it to our format when the spreadsheet will do this automatically. Bhooma should be able to help.

What it looks like to me is that Joey isn't getting enough insulin. In addition, you are holding the dose way too long. If you are giving your cat a dose that isn't bringing the numbers into the range you want, your cat's body begins to treat the higher numbers as his new normal. This state is referred to as glucose toxicity. It's why the dosing protocols we use push for dose changes after no more than a week unless your cat drops into numbers that indicate you need to reduce the dose. With SLGS, you review the numbers every week and adjust the dose accordingly.

The other thing that is happening is that when Joey does drop into a lower range, his liver and pancreas panic! As a result, these organs release a stored form of glucose along with counterregulatory hormones that cause the numbers to rise again. We refer to this as a "bounce." It's a protective mechanism that most caregivers find annoying but it's a normal response. Once Joey gets used to being in better numbers the bouncing should become less of an issue.
 
Hi all,

we’ve been updating Joey’s numbers in the spreadsheet. There was one day where Joey’s nadir was above 5 but below 8. Otherwise his nadir has been above 8. Do we increase the insulin dose from 2.75 to 3 units?
Thanks,
Brittany
 
Hi can you update your spreadsheet, are you still using the Libre ? I see in the remarks column the Libre stopped working , I assume you tested with a human meter
 
Hi can you update your spreadsheet, are you still using the Libre ? I see in the remarks column the Libre stopped working , I assume you tested with a human meter
Correct, on the days we note his libre wasn’t working we did eat pricks but we aren’t able to take very many.
 
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