01/11 Luna AMPS 173

Michaela & Luna

Michaela & Luna

Member Since 2021
Hello!

Luna was switched from to Lantus (from Vetsulin) on Dec 31st. She was prescribed 2 units/twice a day but had a very low number on Jan 1st. We reduced to 1 unit, and after some lows and then rebounds we went to .5 units. She has been staying mostly in the mid to high 100's on .5 units 2x daily. We want to keep with that for a few more days and then try tight regulation.

We use an alphatrak, but the directions for tight regulation are for human meters. How do I know at which number to increase or decrease dosage according to alphatrak numbers? Does if correspond to the colors in the FDMB spreadsheet?

Other info: feeding twice daily FF pate. Considering one of the zero carb dry foods on an automatic feeder as a mid-day snack. Vet wants to check fructosamine and liver enzymes soon (enzymes were slightly elevated at diagnosis). Her neuropathy seems to be improving since we started Lantus!

THANK YOU!
 
Welcome. Here is your post from main/health. We link them for continuity.
https://felinediabetes.com/FDMB/threads/newly-diagnosed-and-insulin-help.257199/#post-2899601

I see Bron suggested you lower the dose to .50. The depot takes 5-7 days with the first shot. See how the bg is for a couple more days. We increase and decrease in .25 increments going forward. Do you have syringes with half unit markings? I am glad you will try TR. It gives you the best chance at remission.

How high were the liver enzymes? My internist told me unless more than double the high norm if the ALT is elevated he wasn’t concerned. I personally would wait for the fructosamine if you test enough at home. With TR you need a minimum of two tests each cycle. Cats often drop lower at night so night tests are important. How is the testing going?

You don’t need zero carb food. Some cats even do better on 6-9%. It depends on how carb sensitive your cat is. Most of us feed at least 3 mini meals each cycle. The auto feeder comes in handy if away from home and at night.
 
Michaela & Luna said:
We use an alphatrak, but the directions for tight regulation are for human meters. How do I know at which number to increase or decrease dosage according to alphatrak numbers? Does if correspond to the colors in the FDMB spreadsheet?
Click to expand...
It depends on which dosing method you are using as to the actual reduction/increase numbers. But taking a look at your spreadsheet, it looks more like you are following the Start Low Go Slow Method. For the SLGS method, we just use the same numbers, regardless of meter. We have no way of converting between the two, and in the lower numbers they are close enough when people have done comparisons. So for SLGS, you goal is to get nadirs in the 90-150 range. Unfortunately you only have the one test done other than the preshot tests at this dose. So my first suggestion would be to either do a curve, or get some spot checks in the AM and PM and see how low the dose is taking Luna. And even based on the preshots, my guess is the nadirs are either in the right range, or perhaps too low. You reduce if they go below 90 per SLGS.
 
If you are going to follow TR, we still need to know how low this dose is taking Luna. Whether that's a curve (to help you learn her onset and nadir times) and some spot checks. TR requires a minimum of 4 tests per day, the two preshots plus one other in each of the cycles. For the night time, a before bed test if it's at least 2 hours after shot time, is a good one. So my suggestion of gathering more data on this dose still holds.

As far as AT numbers vs. human meters, the reduction point in the AT is 68 for TR, vs 50 on a human meter. Otherwise the numbers are taken at face value.
 
Thank you Wendy! We are planning a curve on Friday and holding the 0.5 dose until we do that. I just wanted to kind of wrap my head around tight regulation before we started.
 
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