10/12/2020 Tipsy Lantus dosing advice needed

[Tipsy]

Hi Folks, Tipsy is 8 years old and has been on Lantus since the 24/9/2020 and we’ve recently done dose reductions as his nadir levels were starting to run higher than his preshot levels. Unfortunately this trend has pretty much continued even on a lower dose of Lantus so needing to know where to from here. He is on Fancy Feast pates and Ziwipeak air dried chicken as a free feed. Please note that I’m in Australia and don’t have access to 1/2 unit syringes so microdosimg is difficult.
Link to his spreadsheet below.

https://docs.google.com/spreadsheets/d/1kxBhvLDt7Nvobsl8S7s2IGJdr4nwGwUdL5-6O9Kl9rM/edit

 

[tiffmaxee]

Welcome. First off, if you can’t get syringes with half unit markings, you can use digital calipers. As far as supplies go, we have members from Australia who can help. @Bron and Sheba (GA)
Looking at your spreadsheet you never should have decreased his dose. Have your read our dosing methods?
https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/

One unit was not enough insulin. The nadir is not always at +6. It can be earlier or later. However rather than a decrease an increase was called for. I would go back to 1.0.

 

[Tipsy]

Welcome. First off, if you can’t get syringes with half unit markings, you can use digital calipers. As far as supplies go, we have members from Australia who can help. @Bron and Sheba (GA)
Looking at your spreadsheet you never should have decreased his dose. Have your read our dosing methods?
https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/

One unit was not enough insulin. The nadir is not always at +6. It can be earlier or later. However rather than a decrease an increase was called for. I would go back to 1.0.

Hi there, I was advised by admins of another page to reduce his dose after he dipped into the blue several times. I’m still very new to this. I’m also legally blind so not sure how useful a digital caliber will be for me.

 

[Tipsy]

Forgot to add that I’m not always home to get a daytime +5 or +6 reading as I work afternoons and use public transport to get around so often have to leave home at the mid cycle time. It’s also not possible to get a mid cycle during the night as that works out to be 1-2am and given I suffer from bouts of insomnia I need to keep to a strict sleep routine as much as possible.

 

[Chris & China (GA)]

I was advised by admins of another page to reduce his dose after he dipped into the blue several times.

I don't know who told you that, but we want our kitties in low blues and even greens! (50-99).

Some of his best numbers were when he was on 1U.

Do you mean the one time you had a PMPS of 119 you were told to reduce?

I totally agree with @tiffmaxee that you should go back to the 1U dose. I'd also suggest getting at least 1 "before bed" test on the PM cycle. Most cats go lower at night so it's important for safety. Also, if you don't get tests on the PM cycle, you're missing half the data! That's like trying to figure out what the puzzle is when you don't have any pieces filled in on the right side.

You don't necessarily have to get a mid-cycle on the PM....just a +2 or +3 to make sure he's not dropping too quickly overnight

 

[Bron and Sheba (GA)]

Hi there, I was advised by admins of another page to reduce his dose after he dipped into the blue several times. I’m still very new to this. I’m also legally blind so not sure how useful a digital caliber will be for me.

Hi and welcome to the forum. Here is a link for Australian caregivers
https://www.felinediabetes.com/FDMB/threads/information-for-aussie-feline-diabetic-caregivers.217781/

And another one On how you can help us help you!
https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

I agree with Elise, you need to increase the dose of insulin. Dropping into blue is not a reason to reduce the dose.
Well done looking after Tipsy when you are legally blind. If we can help in any way please let us know.

 

[Tipsy]

I don't know who told you that, but we want our kitties in low blues and even greens! (50-99).

Some of his best numbers were when he was on 1U.

Do you mean the one time you had a PMPS of 119 you were told to reduce?

I totally agree with @tiffmaxee that you should go back to the 1U dose. I'd also suggest getting at least 1 "before bed" test on the PM cycle. Most cats go lower at night so it's important for safety. Also, if you don't get tests on the PM cycle, you're missing half the data! That's like trying to figure out what the puzzle is when you don't have any pieces filled in on the right side.

You don't necessarily have to get a mid-cycle on the PM....just a +2 or +3 to make sure he's not dropping too quickly overnight

It was also due to the mid cycles being higher than the preshot whilst on the 1U dose.

 

[Tipsy]

Hi and welcome to the forum. Here is a link for Australian caregivers
https://www.felinediabetes.com/FDMB...for-aussie-feline-diabetic-caregivers.217781/
https://www.felinediabetes.com/FDMB...for-aussie-feline-diabetic-caregivers.217781/
And another one On how you can help us help you!
https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

I agree with Elise, you need to increase the dose of insulin. Dropping into blue is not a reason to reduce the dose.
Well done looking after Tipsy when you are legally blind. If we can help in any way please let us know.

Ok thank you, will give him 1U tonight and see how he goes. It’s almost time for his daytime +6 test now. can the heat be effecting his numbers? The last few days have been above 35C here with one day at 40C

 

[Bron and Sheba (GA)]

Ok thank you, will give him 1U tonight and see how he goes. It’s almost time for his daytime +6 test now. can the heat be effecting his numbers? The last few days have been above 35C here with one day at 40C

Unlikely the heat would effect his BG numbers. Cats like the heat.
It’s lack of insulin that is causing the higher numbers. Just make sure he is drinking enough.

 

[tiffmaxee]

Thanks @Bron and Sheba (GA) and @Chris.and China.

 

[Wendy&Neko]

Hello and welcome from me too.

It was also due to the mid cycles being higher than the preshot whilst on the 1U dose.

The reason he might have been going higher during the daytime mid cycles (there is little evidence what happens at night), is that he might have been going lower at night and bouncing during the daytime. Many cats go lower at night, so it's very common to see some daytime bouncing. If you can get a test just before bed each night, that would really help us see what he's doing and how low the dose is really taking him.

Good luck with the new dose.