Once daily doesn't work with most cats. Lantus/Lev are dosed once a day in people, but cats have a fast metabolism and it basically leaves them untreated for 12ish hours. A better goal is to find a dose that can be given twice a day.
Do you want dosing help from the Tight Regulation guidelines or the
Start Low Go Slow. TR pretty much requires at least 3-4 tests a day - both preshots and one mid-cycle per day.
I'm going to give advice based upon SLGS, so tell me if you want it from TR. With SLGS, you reduce if you catch a test under 90. So based upon the 53 you got yesterday, you would reduce the dose to 0.75u every 12 hours. With SLGS you would need to do a curve every 2-3 hours for 12-18 hrs (see below.)
I'll just add that it looks like Phoenix's pancreas is healing. When we see a kitty beginning to work their way down the dosing scale, it becomes even more important to have some confidence about how low the dose is taking her. You just want to keep her safe, of course - nothing more precious than our kitters. Putting Neosporin ointment with pain relief on her ears will help them heal overnight and will numb any of the ouch from the poking. Punkin lived 2.5 years after diagnosis and his ears looked pristine. Vets remarked on how you would never have known that he was getting tested multiple times every day. I slathered it on every night and wiped off any remaining in the morning. Try it and see if that helps. Also, always give a treat after you poke and she will learn to associate the test with the treat. Make sure you apply pressure with your thumb/finger for a few seconds after you poke to staunch the bleeding and prevent bruising. All of that should make the whole process easier for both of you, while keeping tabs on her BGs and keeping her safe.
Really exciting to see her doing so well!!! julie
Start Low Go Slow:
Hold the dose for at least a week
- Unless your cat won’t eat or you suspect hypoglycemia
- Unless your kitty falls below 90 mg/dL (5 mmol/L) if kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours
Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet.
- If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
- If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
- If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
- As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], do lengthen the waiting time between dose increases. If you decide to change another factor (e.g., diet or other medications), don't increase the insulin dose until the other change is complete (but do decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change). Don't be tempted to rush the process along by increasing the dose more quickly or in larger increments-- no matter how high your cat's blood glucose is! Rushing towards regulation will cost you time in the long run, because you may shoot past the right dose.
Lather, Rinse, and Repeat!
