Advice on dosage reduction
- Thread starter Evey
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Diane Tyler's Mom GA
Member Since 2018
For some reason when I tap on Evey's spreadsheet nothing comes up
By the way you need to put the year she was diagnosed in your signature.
I looked back at your original post and saw it was in 2023 ,you need to add that to your signature and what meter you are using and what dosing method you want to follow
@Evey
I just got your SS to come up on my cell phone weird, can't see it when I use my tablet
What dosing method are you following TR or SLGS?
If you are following SLGS you would reduce anytime she drops under 90
I see she dropped to 41 US numbers so you need to reduce to 0.75 tomorrow morning. Your new dose would be 0.75 units
Did you feed her anything after those two BG's of 41?
Here is your previous post
https://www.felinediabetes.com/FDMB...ose-but-never-gets-there.287338/#post-3158596
Take a look at the dosing methods
https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/
If following TR then you reduce every time she drops under under 50.
I see you asked about feeding smaller meals during the day
Absolutely, most feed about 2 teaspoons of low carb wet food around +2 and +4 for both cycles.
Do you have a hypo kit set up medium and high carb wet food
I don't know where you live or I would suggest some
@Evey
By the way you need to put the year she was diagnosed in your signature.
I looked back at your original post and saw it was in 2023 ,you need to add that to your signature and what meter you are using and what dosing method you want to follow
@Evey
I just got your SS to come up on my cell phone weird, can't see it when I use my tablet
What dosing method are you following TR or SLGS?
If you are following SLGS you would reduce anytime she drops under 90
I see she dropped to 41 US numbers so you need to reduce to 0.75 tomorrow morning. Your new dose would be 0.75 units
Did you feed her anything after those two BG's of 41?
Here is your previous post
https://www.felinediabetes.com/FDMB...ose-but-never-gets-there.287338/#post-3158596
Take a look at the dosing methods
https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/
If following TR then you reduce every time she drops under under 50.
I see you asked about feeding smaller meals during the day
Absolutely, most feed about 2 teaspoons of low carb wet food around +2 and +4 for both cycles.
Do you have a hypo kit set up medium and high carb wet food
I don't know where you live or I would suggest some
@Evey
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Yes, you should reduce the dose to 0.75 units. Even the most aggressive dosing method here has you reduce when the dose takes your cat below 50, which 1.0 unit has done several times. It would be potentially dangerous to keep her on a dose taking this low.
Have you received any dosing guidelines from your vet?
Have you received any dosing guidelines from your vet?
Evey
Member Since 2024
I did received dosing guidelines from my vet. Here is the guidlines he gave me: 10+: 1.5U, 6-9.9:1U, 5.9-：0.5U
As you can see from the SS, her BG is always between 6-9.9 before i gave her the shot so I kept giving her 1U. My vet also mentioned that it's ok to be under 3.9mmol or low when using the Libre Freestyles as long as the cat doesn't show any symptoms of hypoglycemia because the acutual BG number could be higher than the readings from the Libre Freestyles sensor. I don't think my kitty ever show any symptoms of hypoglycemia.
One thing I noticed that is her BG level never goes down really low in the daytime(mostly blue), so i wonder if 0.75 units would be enough to keep her BG down within the reasonable range. I guess I will find out when I get home tonight.
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Evey
Member Since 2024
To be honest, I don't know which one I should follow. I don't know which is good or suitable for my cat. I've been following my vet's dosing guidlines but there is not much progress recently. I uploaded the BG curves from the preivous months. I'm happy to hear your opinions about which method is better for her.
I gave her 0.75 units this morning. I have never gave her 0.75U before and I'm not sure if I drew the correct dosage since there is no 0.25 mark on the syringe. I just make sure the the top of the rubber is between the 0.5-1 mark. Hopefully whatever I gave her would be enough to keep her BG down/stable.
After her dosage is changed to 0.75 units, I should keep giving her 0.75U for several days, right? I'm sorry if I'm question is dumb. It's really confusing for me. I don't quite understand this two method.
"Did you feed her anything after those two BG's of 41?" The vet said as long as the cat doesn't show any symptoms of hypoglycemia, it's fine because the Libre Freestyle readings might be lower than the actual BG number. So the answer is no, I didn't feed her anything because i don't think she has symptoms of hypoglycemia.
About feeding food at +2 and +4 for both cycles, do i need to give her food when I give her insulin? or I only need to give her food around +2 and +4 for both cycles?
What is a hypo kit? I used to feed her Ziwi wet food, now I switch to Leonardo wet food based on others recommendation. I'm living in China and the options are quite limited to be honest.
We've seen wide variations when comparing the Freestyle to a hand held meter, though they are much closer together in low numbers.
Yes, you would stay with 0.75 units for several days to see how she does on it. We dose Lantus based on how low the dose takes the cat, not the preshots. Ideally her lows would be above 2.8 (50).
For feeding, yes, give her food at shot time. Our sequence is test (easy to do with Libre), feed, and shoot.
A hypo kit includes higher carb food, syrup or honey. More details in here: jojo and bunny's HYPO TOOL BOX
No dumb questions here.
Yes, you would stay with 0.75 units for several days to see how she does on it. We dose Lantus based on how low the dose takes the cat, not the preshots. Ideally her lows would be above 2.8 (50).For feeding, yes, give her food at shot time. Our sequence is test (easy to do with Libre), feed, and shoot.
A hypo kit includes higher carb food, syrup or honey. More details in here: jojo and bunny's HYPO TOOL BOX
Evey
Member Since 2024
We've seen wide variations when comparing the Freestyle to a hand held meter, though they are much closer together in low numbers.
No dumb questions here.
For feeding, yes, give her food at shot time. Our sequence is test (easy to do with Libre), feed, and shoot.
A hypo kit includes higher carb food, syrup or honey. More details in here: jojo and bunny's HYPO TOOL BOX
This is very different from what the vet told me. When I gave her 1 unit, the same amount of dosage didn't take her down to the same level. Her lows in the daytime usually higher than those in the night time. if the morning shot didn't get her below 50, do I still need to change the dosage?
Yes, we don't want her below 50 at any time day or night.
Evey
Member Since 2024
I gave her 0.75 units last night and I noticed that her BG drop really fast an hour after the shot (from 151 to 76). Did it drop too fast?
Last night, I started to change her feeding time and fed her 30g with the insulin shot, then 35g at +2 and 35g at + 4. It seems in general her BG is higher than the nights i didn't feed her at +2 and +4. Her AMPS BG is relavtively higher than in the past too. Is it normal? I added another sheet called BG & Food in the SS. Can you help me take a look? Thank you so much.
Lantus is a depot style insulin. Meaning that the larger depot from 1.0 units will influence several cycles after you reduce the dose. The lower numbers you saw tonight are from that 1.0 unit depot.
If you are finding she's dropping really fast at a particular time of the cycle, move that +2 feed up until 1/2 before the typical drop time. The additional food may slow down that drop. Food experiments can take a week or more to see results, I wouldn't attach any meaning to what happened in one cycle.
I'm a little confused. I see a 160 in the PMPS column, and that column is supposed to represent the blood sugar test right before the shot. Typically with Lantus we test (to make sure it's safe to shoot), feed (to make sure they are eating), then shoot. All within about 10-15 minutes or so. Are you doing something different?
If you are finding she's dropping really fast at a particular time of the cycle, move that +2 feed up until 1/2 before the typical drop time. The additional food may slow down that drop. Food experiments can take a week or more to see results, I wouldn't attach any meaning to what happened in one cycle.
Evey
Member Since 2024
Sorry for the confusion, maybe it's better for me to write down the time so it's more clear.
March 7:
19:16 158mg/dl
19:20 160mg/dL shot: 0.75 units food:30g (giving her a shot while she is eating is a lot easier)
20:21 151mg/dl (+1)
21:21 76mg/dL (+2) 21:27 food 35g
22:19 43mg/dl (+3)
23:21 61mg/dl (+4) 23:38 food 35g
March 8:
00:24 83mg/dl (+5)
01:24 94mg/dl (+6)
I hope I'm doing it correctly.
"move that +2 feed up until 1/2 before the typical drop time." do you mean by moving the +2 feed up about half an hour earlier?
March 7:
19:16 158mg/dl
19:20 160mg/dL shot: 0.75 units food:30g (giving her a shot while she is eating is a lot easier)
20:21 151mg/dl (+1)
21:21 76mg/dL (+2) 21:27 food 35g
22:19 43mg/dl (+3)
23:21 61mg/dl (+4) 23:38 food 35g
March 8:
00:24 83mg/dl (+5)
01:24 94mg/dl (+6)
I hope I'm doing it correctly.
"move that +2 feed up until 1/2 before the typical drop time." do you mean by moving the +2 feed up about half an hour earlier?
ok, you have been doing it right and the spreadsheet reflects that.
yes.
Evey
Member Since 2024
Thank you for your help. I've been giving her 0.75 units and her BG is relatively low on average. But her preshot BG is still kind of high. Should I continue to give her 0.75 units or should I reduce it to 0.5 units? Thank you!
She is still going too low. Any time she goes below 50 (2.8), reduce her dose immediately by 0.25 units for the next shot.
Evey
Member Since 2024
ok. I just can't stop worrying about her preshot BG. I will reduce it to 0.5 tonight. thank you so much for your help
What more important that the preshot is how low the dose is taking your cat. The preshot numbers will come down eventually and the morning one is usually the last to come down.
Evey
Member Since 2024
Can I ask why the morning one is usually the last to come down?
I gave her 0.6 last night and her BG didn't go below 50. It seems kind of high compared to previous readings so i changed it back to 0.75 units this morning. I'm not sure if i did it correctly. Should I still give her 0.75 tonight? or I should've given her 0.6 this morning?
For Evey's safety's sake, do not give 0.75 units again. Return to 0.5 units, not 0.6. You do NOT want her going below 50, that is way too close to being a hypo.
How are you measuring that 0.6 units vs. 0.5?
We aren't entirely sure why the AMPS is typically the last number to come down. It could be it's something to do with dawn phenomenon, or bouncing from going lower during the night. Regardless, don't worry about slightly higher AM numbers.
How are you measuring that 0.6 units vs. 0.5?
We aren't entirely sure why the AMPS is typically the last number to come down. It could be it's something to do with dawn phenomenon, or bouncing from going lower during the night. Regardless, don't worry about slightly higher AM numbers.
Evey
Member Since 2024
Evey's BG is not going down a lot recently. I changed it back to 0.75 units and it didn't take her down very low. Should I increase the doseage back to 1?
0.75 units is still taking her below 50. That dose is too much insulin. You don't want to be on a dose that is taking her that low. Please reduce to 0.5 units for her safety. And stay at that dose for at least 3 days. Last time you only shot 0.5 units for one dose. That's not long enough due to the depot nature of Lantus.
Evey
Member Since 2024
I didn't check this board due to internet problem so I've been giving her 0.75 units. I'm lucky that she didn't drop below 50 for the last couple days.
On the 19th, she ran out of Leonardo can food so i gave her 10g of orijen (no grain) and 40g of orijen next day mixed with leonardo can food. After she had that, her blood sugar went crazy and is prett high now. Is it because of the food? I'm so frustrated now.
Your spreadsheet indicates you'll be shooting 1.0 units tomorrow. Please don't, she's getting low enough on this current dose that there isn't really any room for an increase.
Which specific Orijen product did you feed her? I don't see a lot of difference in her numbers between the days you fed Orijen and the days you didn't.
We look at how low the dose is taking her. 0.75 units is taking her to the 60's, that a good dose to stay with as long as she doesn't go any lower.
Which specific Orijen product did you feed her? I don't see a lot of difference in her numbers between the days you fed Orijen and the days you didn't.
We look at how low the dose is taking her. 0.75 units is taking her to the 60's, that a good dose to stay with as long as she doesn't go any lower.
Evey
Member Since 2024
I gave her Orijen Regonal Red. I think I'm one day ahead of you. I gave her 1 unit this morning, not tommorrow.
Maybe I'm overreacted. I don't see that much green and all I saw are mostly blue. Like last night and today, all blue and no green so far. There used to be more green, especially in the evening. Also the vet told me that her chance of getting remission is really low now.
That makes me even more anxious. I really hope that she can get to remission. I really hope this TR method will work. T_T
There is an explanation for why the numbers tend to be higher first thing in the morning. It's called "dawn phenomenon." Numbers go up in the early AM as the body prepares itself for the stress of the day. The adrenal glands release stress hormones to address the anticipated stress. Those hormones will raise blood glucose levels especially in diabetics since their body isn't producing insulin in the quantity that is necessary to keep blood glucose levels in a better range.
Have you eliminated dry food from your cat's diet? In order to follow TR, you cat needs to be on a low carb canned food diet.
Have you eliminated dry food from your cat's diet? In order to follow TR, you cat needs to be on a low carb canned food diet.
Evey
Member Since 2024
Thank you for the explaination. That makes sense.
Yes. I only feed her wet food now.
Evey
Member Since 2024
I found out that the reason why her BG was not really dropping was because of the expired insulin. I bought a new one and she is going back on track again. However, it seems this insulin doesn't take her down as fast as or as much as the previous one. Is it dropping slowly and not too much a good sign?
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