5/4 Dyson AMPS 546 +2 531 +4 504 +6 433

Welcome to LLB. e take the previous dose into consideration when deciding on a starting dose of Lantus. So I think 1.0 is not enough. Before deciding on what that dose will be you are asking about using the TR method. That would mean not feeding any dry food. I thought I read you were trying to limit the dry? Are you now feeding only canned or raw? If so TR would get Dyson controlled much faster. You definitely are testing enough.
 
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Also, antibiotics are not usually used as a first treatment for pancreatitis. You treat the symptoms which are often nausea causing inappetence, pain, and fluids. Max had chronic pancreatitis before becoming diabetic and his first sign of a bout was inappetence which was treated with ondansetron. I think I saw Dyson is eating well so either he did not have pancreatitis or it’s no longer present. That’s good.
 
tiffmaxee said:
Welcome to LLB. e take the previous dose into consideration when deciding on a starting dose of Lantus. So I think 1.0 is not enough. Before deciding on what that dose will be you are asking about using g tge TR method. That would mean not feeding any dry food. I thought I read you were trying to limit the dry? Are you now feeding only canned or raw? If so TR would get Dyson controlled much faster. You definitely are testing enough.
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I agree that 1u is likely not enough. It is the mathematical starting dose based on his weight which is what the vet said to start at. We were also unsure of how he would react to Lantus so thought it better to start a little low rather than drop him into a hypo by being too aggressive.

At this point we only feed him wet canned food and freeze dried chicken or beef liver. He does sometimes sneak a couple bites of elsey’s/epigen90 when we aren’t fast enough to take away his brothers’ food, but that’s *very* rare. (Working on switching them all to wet, but one of them is being stubborn.)
As far as the antibiotics, pretty sure the vet was just trying to eliminate any other issues that could be contributing since the internist did mention possible infection/inflammation issues.
 
I think it’s a good idea to switch to TR. How much does he weigh? I did not read through all your previous comments. Was he ever hypo or his bg under 90? I understand being afraid of a hypo but starting at 1.0 is really low. You don’t need to start at 3.25 or even 3.0 but 1.0 especially if you will not follow TR will take a long time to get to a good dose. Just my two cents FWIW.
 
Since we have been monitoring him and testing him his glucose has only ever dropped into the mid to low-200s, and that was only a couple times. He’s never even been close to hypo. Right now he weighs about 10lbs(4.5kg)
 
tiffmaxee said:
I think it’s a good idea to switch to TR. How much does he weigh? I did not read through all your previous comments. Was he ever hypo or his bg under 90? I understand being afraid of a hypo but starting at 1.0 is really low. You don’t need to start at 3.25 or even 3.0 but 1.0 especially if you will not follow TR will take a long time to get to a good dose. Just my two cents FWIW.
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I should have said: I think we will switch to TR, just need to read it a few more times to make sure I fully understand it. But given that 1 is low, what do you think is a good amount? Should we move him to 1.5 tonight and maybe 2 in the morning? (since we can monitor him all day a lot easier than overnight.)
 
Lantus works very differently than Vetsulin. It’s a depot insulin and it takes 5-7 days for tge initial depot to build. You hold the initial dose for 5-7 days if following TR and after that you don’t increase sooner than every 3 days. Typically it kicks in around +2-3 and reaches nadir, lowest bg in tge cycke around +5-7. most. So if the bg is lot lower than the preshot at +2-3 you might have an active cycke requiring another test. If not you won’t need to test more that cycle unless you are around ir awake and can get a mid cycle reading. . Occasionally a cat will get a strong reaction to the first cycle but not usually. I’d give 2.0 tonight but if you feel uncomfortable then increase in the morning. You want to pick a dose and hold it to let the depot build. Your goal is to get the bg mostly in the range of a cat that’s not diabetic which is 50-100 in a human meter. That takes time as we increase in .25 increments and if the nadirs are over 300 then in .50 increments. So as you can see you are not close to a potential hypo.
The stickies at the top of this forum are really helpful but can be overwhelming so ask as many questions as you need and someone will answer you .
 
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