Is this dose too low or too high

[JaniceC]

Almost 10 days since I increased from 1.25 to 1.5 Lantus and the glucoses are not going lower. They are in the upper 200’s mostly but they were a little lower at 1.25 sometimes in the 250’s. They just seem to be stuck. I dont know if I should have held the dose longer at 1.25 instead. Felix's SS is not updated on my signature yet but here is another SS. Hope you will be able to view this SS.

https://docs.google.com/spreadsheets/d/1_5_kqbfRDit6n5n-wQ7Y1hpSW_KrGhTZbCD7JJM-HLs/edit
Felix (Janice Ho Lung Chin) 's Sugar Sheet

 

[Chris & China (GA)]

I'd like to see you getting at least 1 test on the PM cycle, like a "before bed" test (getting a test 2-3 hours after the shot can often give you a "heads up" to where he might be going later in the cycle. Most cats go lower at night so it's really important to know he's going to be safe before you sleep (or if you need to either stay up or set an alarm to test later in the cycle).

Have you read the information about the 2 different dosing methods we use for Lantus? Here is the information: Sticky - Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)

I also see you are a member of the Feline Diabetes Support group on Facebook. (you're using their spreadsheet). There is also another big group called Feline Diabetes. The Feline Diabetes group is associated with this board so we use the methods we all learned here. This board has been helping diabetic cat caretakers for over 25 years...before Facebook was even a thing, so there's tons of experience here and lots of information to read in the Lantus support group. The FDSG has their own way of doing things so trying to learn from them as well as here can be very confusing so you might want to decide on one or the other.

 

[JaniceC]

I read the info in the Lantus support group and all of the of the other information I could find to learn about dosing etc. but I am confused about how to decide whether to increase or decrease a dose. I have tested a few times 3 hrs after his pm shot and his glucoses have always been higher than his preshots. He seems to have a flat curve and his SS glucoses don’t behave the way you expect since they fluctuate so much. It’s not clear whether I should increase or decrease this dose. I am wondering if I should go back to the 1.25 dose or continue with the 1.5 a little longer.

 

[Chris & China (GA)]

I have tested a few times 3 hrs after his pm shot and his glucoses have always been higher than his preshots.

You need to test on every cycle. Cats have a funny habit of changing things often. Also, if you think of your spreadsheet like it's a puzzle, by not having tests on the PM cycle, you're only seeing half the "picture".

If we assume you're using the Start Low, Go Slow dosing method, you didn't hold the 1.25 long enough, but you've held the 1.5 over 8 days. On SLGS, after 7 days on a dose, you need to do a curve (testing every 2 hours for 12 hours or every 3 hours for 18 hours).

We are very data-driven here. Without those additional tests, I'm hesitant to suggest going up to 1.75, but I don't think dropping back to 1.25 is the answer either. Can you do a curve anytime soon?