Freya BG update; mixed results

[SwedishLiz]

Freya was very stressed on her journey to the vet yesterday (she both pooped &puked, plus panic-panted…)
so we weren’t expecting her BG values to be ‘perfect’ but 18.8 mmol/L (338.4 US)? Despite a week of Lantus, her BG
has barely reduced!
As a result, the vet has increased her Lantus to 2.5 units BD. Don’t shout at me, I know, but I need to get her BG down!
Once back home, we tested again. 17.9 mmol/L (322.2 US) so still ridiculously high. As a result, we gave the increased dose of 2.5 units of Lantus, then left it a couple of hours.
Next BG test was 2.8 mmol/L (50.4 US)! As a result, we’ve fed her some of her favourite treats just to make sure she won’t go hypo overnight! Last BG test before bed was 16.9 mmol/L (304.2 US) but hopefully her BG will drop as she sleeps…
Despite the vet’s suggestion that a new BD dosage of 2.5 units is needed, tonight has shown that it’s too high so we’ll use our own judgement tomorrow morning dependent on Freya’s BG values! SS update to follow.

 

[Bron and Sheba (GA)]

Liz, have you been taking her BGs at home? I can’t see any BG data in the spreadsheet.
Lantus dosing is based on the nadir ( lowest point ) in the cycle not the Preshot BG.
Increasing her dose based on 1 Preshot BG taken at the vet when Freya was obviously very stressed ( having pooped and peed in the car on the way to the vet) is fraught with danger.
Any increase should be based on how low the current dose is taking Freya.
I would strongly recommend you look at the two dosing methods I will post below and pick one that suits you and follow it closely to get the results you want.
Dropping so quickly to 2.8 (50) tell me that the dose the vet suggested was too high and was based only on one Preshot BG from a very stressed cat.
If I were you I would go back to the dose you were giving before the vet visit and ask for advice here.

 

[Bron and Sheba (GA)]

DOSING METHODS

 

[SwedishLiz]

Liz, have you been taking her BGs at home? I can’t see any BG data in the spreadsheet.
Lantus dosing is based on the nadir ( lowest point ) in the cycle not the Preshot BG.
Increasing her dose based on 1 Preshot BG taken at the vet when Freya was obviously very stressed ( having pooped and peed in the car on the way to the vet) is fraught with danger.
Any increase should be based on how low the current dose is taking Freya.
I would strongly recommend you look at the two dosing methods I will post below and pick one that suits you and follow it closely to get the results you want.
Dropping so quickly to 2.8 (50) tell me that the dose the vet suggested was too high and was based only on one Preshot BG from a very stressed cat.
If I were you I would go back to the dose you were giving before the vet visit and ask for advice here.

Thank you for this! Freya’s spreadsheet has now been updated…
We’re going to try the TR regime starting tonight on a dose of 2.25 units.
Thank you for the advice!

 

[Sienne and Gabby (GA)]

A couple of points for your consideration...

Most cats are stressed by a vet visit. It sounds like Freya is also not a big fan of car rides. (She may get motion sick.) Any source of stress will cause a spike in blood glucose levels. One of the issues with getting a test at the vet's office is that the numbers are artificially high. It's far better to base your dosing on the numbers you see at home when your cat is in her normal surroundings and not stressed by the car, a strange place with strange people, sounds and smells.

Lantus doesn't have an immediate reaction on blood glucose numbers. It takes about a week for it to build up in your cat's system. When you give a shot, Lantus forms microcrystals that are deposited in the fat tissue. These crystals dissolve slowly which gives the insulin its long duration. It also allows for the cycles to overlap. This is referred to a "depot." It takes about a week for the initial depot to stabilize and then any time you change a dose, it can take up to 3 days for the depot to get caught up with the change.

Not seeing much of a response after a week is not unusual. If there is one thing that managing your cat's diabetes will teach you, it's patience!

 

[Larry and Kitties]

We’re going to try the TR regime starting tonight on a dose of 2.25 units.

The SS shows on 2/10 with a PMPS of 322 you got a BG of 50@+3 and 304@+5
To me that indicates that 2.25U is too high. Even 2 units is likely too high. When dose is too high one common sign is that BG show little drop and that is what I see in the SS for AM 2/10