Pringles - dosing advice needed

Ilse - M - T - P

Ilse - M - T - P

Member Since 2020
Hi,

Pringles pancreas got Kickstarted :)
He got up to 5 units BID and his numbers suddenly dropped to beautiful blue and greens.
With them dropping so low, so suddenly I am a bit lost as what a good dose would be.
I am home so I could do tight regulation. Although I am a bit intimidated for a potential hypo (although I have a hypo kit ready).

Could someone please look at Pringles spreadsheet (there are multiple cats listed, so please check that you are in Pringles tab) and advice on a good dose?

A challenge is that I will be leaving on the 30th for 2.5 weeks, so not sure if TR is appropriate to start now as I will probably have to lower the dose while I am out of country (the petsitter comes twice a day and tests, and will stay over once in a while, but he won't be as supervised as usual)

Thank you
 
Clarification: you are giving 2.5 units BID, not 5 units BID (BID = twice daily). Is this correct, 2.5 units each injection? When was Pringles diagnosed? Do you have data prior to the spreadsheet at all?

Since Pringles is on Lantus, you need to give the same exact amount AMPS and PMPS. You don't move the dose around since it's a long-acting insulin with a depot. I'm not sure why you decreased from 2.5 to 2.25? And why are you sometimes shooting 2 units and sometimes 2.25? Have you had a chance to read the SLGS protocol?

If you're not going to be around, I would NOT suggest TR at this time.
 
No, I built him up to 5 units twice a day.
Two days ago he suddenly dropped into low 100s.
I don't feel comfortable giving him 5 units when he is low 100s preshot.
So I only gave 4 units yesterday evening this morning. This evening he was 131, so I only gave 3 units.
Since he suddenly dropped so low, so suddenly, i don't have numbers to base myself on for the correct dose.

I have reached out to the vet, but since it is evening, I was hoping to get some support here for tomorrow morning until I hear back from the vet.
 
Ok, I see, so you are still trying to figure out what dose to give him then? Let me tag @tiffmaxee and @Bandit's Mom who I believe were helping you last month. I don't have any past data to know how to reply.

Just to make sure I am understanding correctly - you are concerned about the dose because you are going out of town for 2.5 weeks soon and want him to be safe while you are gone. Because of that, you are bringing down the dose. Is all of this correct?

Do you have any data for when he dropped into the low 100s on the 5 units? How long had he been on 5 units before he went into the 100s? In order to help you, we NEED to see data.

Just so you know - 4 units yesterday, 3 units today - that's not how Lantus works. Lantus has a depot that fills and drains and this takes TIME, over 6 cycles. So you need to pick a dose and stick to it. You adjust the dose based on the SLGS protocol guidance.

I would listen to Elise and Bhooma's advice on which dose he needs to be on right now.
 
My spreadsheet is up to date. Not sure if you are looking at Pringles spreadsheet?
I upped to 5 units on the 12th, when he dropped from high 300s to mid 200, gave another 5 units in the evening on the 12th and the 13th in the morning he was 161. Since then he has been dropping lower for preshots. His nadir are 90.

The 90 would suggest a 0.25/0.5 units reduction, which would be 4.5units.
That seems too much for a 161 or 131. And I know that Lantus is a depot insulin and the dose needs to be consistent but I have to feel comfortable shooting that amount as well. And since he dropped so low so suddenly, I don't

I will wait for Booma's and Elise's feedback
 
Ilse - M - T - P said:
My spreadsheet is up to date. Not sure if you are looking at Pringles spreadsheet?
I upped to 5 units on the 12th, when he dropped from high 300s to mid 200, gave another 5 units in the evening on the 12th and the 13th in the morning he was 161. Since then he has been dropping lower for preshots. His nadir are 90.

The 90 would suggest a 0.25/0.5 units reduction, which would be 4.5units.
That seems too much for a 161 or 131. And I know that Lantus is a depot insulin and the dose needs to be consistent but I have to feel comfortable shooting that amount as well. And since he dropped so low so suddenly, I don't

I will wait for Booma's and Elise's feedback
Click to expand...

OMG, I didn’t realize you have 3 cats attached to the spreadsheet link. I think you need to say that in your signature block no one will understand that the spreadsheet opens to Mango. I am so sorry!! Let me go look at it now and I’ll write again in on a second
 
Ilse - M - T - P said:
My spreadsheet is up to date. Not sure if you are looking at Pringles spreadsheet?
I upped to 5 units on the 12th, when he dropped from high 300s to mid 200, gave another 5 units in the evening on the 12th and the 13th in the morning he was 161. Since then he has been dropping lower for preshots. His nadir are 90.

The 90 would suggest a 0.25/0.5 units reduction, which would be 4.5units.
That seems too much for a 161 or 131. And I know that Lantus is a depot insulin and the dose needs to be consistent but I have to feel comfortable shooting that amount as well. And since he dropped so low so suddenly, I don't

I will wait for Booma's and Elise's feedback
Click to expand...

Ok I am back. I can see your concern, that when you went from 4.5 to 5, on the second cycle he was in blue/green. Given under 90, you’d drop him back down, to 4.75 units. But things got extra complicated then when you started shooting differing amounts 4, 3.5.

I do think you need Elise or Bhooma on this since you have the added complication of shooting differing amounts after a reduction to 4.75 should have happened.

for now I would stop moving the dose around and just stay where you are at until Elise or Bhooma write back with guidance.

Again so sorry about the mixup and looking at Mangos spreadsheet instead of Pringles!

@tiffmaxee @Bandit's Mom
 
We've seen cats suddenly decide they want to be regulated and zoom down the dosing ladder. Fingers crossed that's what Pringles has decided :-)

The depot of a large-ish dose like 5u can affect 4-6 cycles after a reduction. With so many dose changes it is hard to say which dose is working for him. Its good that you are at home and can monitor him because he does seem to have flipped a switch.

I would pick a dose - say 4U - and stick to it for a few cycles unless he earns a reduction. When was Pringles diagnosed with diabetes? Could you please add his DX date to your SS?
 
Bandit's Mom said:
We've seen cats suddenly decide they want to be regulated and zoom down the dosing ladder. Fingers crossed that's what Pringles has decided :)

The depot of a large-ish dose like 5u can affect 4-6 cycles after a reduction. With so many dose changes it is hard to say which dose is working for him. Its good that you are at home and can monitor him because he does seem to have flipped a switch.

I would pick a dose - say 4U - and stick to it for a few cycles unless he earns a reduction. When was Pringles diagnosed with diabetes? Could you please add his DX date to your SS?
Click to expand...

I got him as a diabetic foster on 01Aug2022.
It's unknown how long he had diabetes before he ended up in the shelter. I think for a while since his neuropathy was pretty bad (he is more or less walking normal now) plus his eye sight is also affected.
I will add 01Aug2022 as Dx
 
Bandit's Mom said:
We've seen cats suddenly decide they want to be regulated and zoom down the dosing ladder. Fingers crossed that's what Pringles has decided :)

The depot of a large-ish dose like 5u can affect 4-6 cycles after a reduction. With so many dose changes it is hard to say which dose is working for him. Its good that you are at home and can monitor him because he does seem to have flipped a switch.

I would pick a dose - say 4U - and stick to it for a few cycles unless he earns a reduction. When was Pringles diagnosed with diabetes? Could you please add his DX date to your SS?
Click to expand...

I will keep him at 4 units and do a curve on Sunday.
I tested him at +3 this evening and he was mid 200s
 
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