10/24 Regs AMPS 214 +1 340 +2 338 could anyone review my Lantus dose please?

[Britta and Regs]

Last post
Last night Regs went down to 160 at +7, and I'm not sure how low he went before that. His AMPS of 214 was low enough to make me nervous, but I went ahead and gave him his usual Lantus dose. His +1 was 340, and a second test was even a tad higher. He finished all his food in one sitting today, so I'm not sure if we're looking at a bounce or a mega food bump. We'll see, he seems in very good spirits and that counts most

Would it be smart to raise his Lantus dose from 2.75 to 3 units? Most of the time he stays in the 200, 100s or 300s but sometimes he has the steep drops at night and I dont know why or how to prevent that?

Regs is really enjoying the slightly cooler temperatures. I know he has a lot of fur, but can you see how round he's getting? Damn, I think I need to put him on a diet! Would losing weight change how much Lantus he needs?

 

[Staci & Ivy]

Last post
Last night Regs went down to 160 at +7, and I'm not sure how low he went before that. His AMPS of 214 was low enough to make me nervous, but I went ahead and gave him his usual Lantus dose. His +1 was 340, and a second test was even a tad higher. He finished all his food in one sitting today, so I'm not sure if we're looking at a bounce or a mega food bump. We'll see, he seems in very good spirits and that counts most

Regs is really enjoying the slightly cooler temperatures. I know he has a lot of fur, but can you see how round he's getting? Damn, I think I need to put him on a diet! Would losing weight change how much Lantus he needs?

View attachment 80932

Did you give his dose this am? It’s not written on his spreadsheet.
With SLGS you will want to increase his dose by .25 units every 7 days if he’s not having nadirs in the 90-149 range.
*Unless of course, he has earned a reduction by going under 90, and then you would take a reduction immediately at your next shot.

It appears Regs is not having nadirs in that range consistently, so you may want to ask for a dose review and get some advice (put that in your title and use the ? In the Drop down in the title)
Hope you have a great weekend

 

[Connie & Parker & Moonie]

I agree with Staci

What a handsome handsome boy! He looks just as comfortable lounging in tropical paradise as he did in the forest photos. I think getting fluffier does increase your insulin needs. Mary experienced that with Jude recently, and we have too with Moonie. We’re slowly trying to take her back to where she was but it’s a slow process.

Hope you have a wonderful weekend!

 

[Britta and Regs]

Did you give his dose this am? It’s not written on his spreadsheet.
With SLGS you will want to increase his dose by .25 units every 7 days if he’s not having nadirs in the 90-149 range.
*Unless of course, he has earned a reduction by going under 90, and then you would take a reduction immediately at your next shot.

It appears Regs is not having nadirs in that range consistently, so you may want to ask for a dose review and get some advice (put that in your title and use the ? In the Drop down in the title)
Hope you have a great weekend

Oh sorry I forgot to put the dose in the ss, of course he got it. It's Saturday and I'm a little slow this morning

I really did not think of a dose increase, I still try to recover emotionally from 3 nights ago when Regs dropped so low.
But you might be right, I will throw up my "?" maybe someone could review the dose. Even if my vet would know I shoot him under 250 she would team me not to do it. But who knows where he would be without Lantus today.

Hope Ivy will be better soon that you can enjoy the weekend as well!!

 

[Britta and Regs]

I agree with Staci

What a handsome handsome boy! He looks just as comfortable lounging in tropical paradise as he did in the forest photos. I think getting fluffier does increase your insulin needs. Mary experienced that with Jude recently, and we have too with Moonie. We’re slowly trying to take her back to where she was but it’s a slow process.

Hope you have a wonderful weekend!

Yes I did just throw out my little question mark and ask for a dose review.
After him being so low a couple nights ago, I did not even think about giving him more Lantus.

Regs absolutely loves the weather outside, especially in winter, he would be the perfect outside cat. But the patio looks more tropical than it is, the next house is 15 ft away Two nights ago Rob had to go out with Zero because he had diarrhea and Gizmo, my 19 year old boy, sneaked out on the patio. I couldn't find him in the morning until I looked out of the window and he was sitting there with a very strong cattitude. I was just happy the temperatures did not go below 67 and the patio is enclosed.

Btw Thanks for the recommendation for the Weruva food, Regs and Gizmo both love it, the pouches more than the cans. Especially Gizmo is so picky with food and just licks sauce and he finished his whole portion today.

Hope you all have a great weekend too!

 

[tiffmaxee]

I would go up to 3 units as Staci explained. You aren’t seeing low numbers at night even though it feels that way based upon his day bg.

 

[Britta and Regs]

I would go up to 3 units as Staci explained. You aren’t seeing low numbers at night even though it feels that way based upon his day bg.

Thanks you so much. I am just a bit concerned because he had this one drop 3 nights ago and I was so worried. I'm just not used of Regs being in lower numbers and that's why I'm afraid I could not stop it. On the other side I heard that Lantus on lower numbers gives a more stable curve

 

[Mary & Jude]

Hi Britta, Here is the language from the dosing sticky for SLGS regarding increasing/decreasing:

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. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.

• 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

Regs has seen some numbers below 150 in the past seven days, but, overall, his numbers have been in the above 150 range.

You asked, and, yes, as Connie mentioned, weight gain can result in needing more insulin

Regs tends to experience relatively flat numbers, overall. He has scared you a time or two with some dives (and he's had some spikes, as well) after his shot. But looking at his numbers, they tend to stay relatively flat through the cycle, which is good.

If you want to wait until tomorrow so that you can do more testing tonight to ensure he isn't going below 90 (since he saw 160 last night with a gap in testing leading up to that), that's fine. I prefer to increase Jude in the AM cycle because I can monitor more easily.

When you take the increase, be sure to be ready with supplies to test, etc. Post on the forum if you need to.

 

[Britta and Regs]

Hi Britta, Here is the language from the dosing sticky for SLGS regarding increasing/decreasing:

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. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.

• 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

Regs has seen some numbers below 150 in the past seven days, but, overall, his numbers have been in the above 150 range.

You asked, and, yes, as Connie mentioned, weight gain can result in needing more insulin

Regs tends to experience relatively flat numbers, overall. He has scared you a time or two with some dives (and he's had some spikes, as well) after his shot. But looking at his numbers, they tend to stay relatively flat through the cycle, which is good.

If you want to wait until tomorrow so that you can do more testing tonight to ensure he isn't going below 90 (since he saw 160 last night with a gap in testing leading up to that), that's fine. I prefer to increase Jude in the AM cycle because I can monitor more easily.

When you take the increase, be sure to be ready with supplies to test, etc. Post on the forum if you need to.

Thanks so much again for your help, Mary.

Last night he started out pretty flat at +1 and +2, so I thought I could catch up on some sleep, but ended up sleeping an hour longer than I had planned. And of course, Regs decided to surprise me again while I was sleeping! But remembering everyone here saying that 160 isn't low, I decided to go back to bed for a bit and test again later, and he actually went up without any additional food.

I'll monitor him again overnight, and if everything looks good, I'll try increasing to 3 units tomorrow morning. Thankfully, I'll be home most of the day and can keep a closer eye on him. I definitely feel more comfortable increasing in the morning because if I did it in the PM cycle and he suddenly dropped, I wouldn't know if it was one of his usual steep drops or the increased dose being too much.

It's reassuring to hear that you think his numbers are relatively flat overall. I guess I sometimes focus too much on those sudden drops, but looking back at all the reds and blacks at the beginning of his spreadsheet, we're definitely heading in the right direction!

And about his weight, I'm happy he gained back what he lost, but I think he's enjoying his food a little too much lately

I was also wondering, if I reduced his food a little, could that make the Lantus more effective, or am I wrong about that? I definitely wouldn't want to increase his Lantus and reduce his food at the same time.

 

[Mary & Jude]

Thanks so much again for your help, Mary.

Last night he started out pretty flat at +1 and +2, so I thought I could catch up on some sleep, but ended up sleeping an hour longer than I had planned. And of course, Regs decided to surprise me again while I was sleeping! But remembering everyone here saying that 160 isn't low, I decided to go back to bed for a bit and test again later, and he actually went up without any additional food.

I'll monitor him again overnight, and if everything looks good, I'll try increasing to 3 units tomorrow morning. Thankfully, I'll be home most of the day and can keep a closer eye on him. I definitely feel more comfortable increasing in the morning because if I did it in the PM cycle and he suddenly dropped, I wouldn't know if it was one of his usual steep drops or the increased dose being too much.

It's reassuring to hear that you think his numbers are relatively flat overall. I guess I sometimes focus too much on those sudden drops, but looking back at all the reds and blacks at the beginning of his spreadsheet, we're definitely heading in the right direction!

And about his weight, I'm happy he gained back what he lost, but I think he's enjoying his food a little too much lately

I was also wondering, if I reduced his food a little, could that make the Lantus more effective, or am I wrong about that? I definitely wouldn't want to increase his Lantus and reduce his food at the same time.

You need to decide how much to feed him to accomplish weight goals: loss, gain, maintain. Feeding schedules for FD kitties vary (sometimes because kitties dive after a shot, etc.), but what is ideal for a FD cat is feeding smaller meals spread throughout the cycle, and withholding food two hours prior to the shot (so the preshot number isn’t food influenced). Lantus kitties need food onboard at onset, which is typically around +2. Most people feed and shoot at the same time to get food onboard, but you can feed smaller amounts early on, every hour or so to slow a dive.

 

[Britta and Regs]

You need to decide how much to feed him to accomplish weight goals: loss, gain, maintain. Feeding schedules for FD kitties vary (sometimes because kitties dive after a shot, etc.), but what is ideal for a FD cat is feeding smaller meals spread throughout the cycle, and withholding food two hours prior to the shot (so the preshot number isn’t food influenced). Lantus kitties need food onboard at onset, which is typically around +2. Most people feed and shoot at the same time to get food onboard, but you can feed smaller amounts early on, every hour or so to slow a dive.

Wait, I need to feed Regs at +2 when the Lantus kicks in? I thought feeding him at shot time a big meal and giving him his lunch and nighttime snack was enough.
I am withholding food at least 2 hours before the shot, so at least I'm doing something right.
Maybe I should start splitting his main meals into smaller portions instead of giving him everything at once. Would that also help with those sudden drops he sometimes likes to surprise me with?

As for his weight, I don't really want him to lose much, I just don't want him to keep gaining. His brother is 21 lbs, but he's a big boy, and I really don't want little Regs to get there too

 

[Mary & Jude]

Wait, I need to feed Regs at +2 when the Lantus kicks in? I thought feeding him at shot time a big meal and giving him his lunch and nighttime snack was enough.
I am withholding food at least 2 hours before the shot, so at least I'm doing something right.
Maybe I should start splitting his main meals into smaller portions instead of giving him everything at once. Would that also help with those sudden drops he sometimes likes to surprise me with?

You don't have to feed at +2. Feeding a meal at shot time is fine--that usually gives them the food they need for onset, which is typically around +2. That's what I do with Jude, who is a grazer, and eats a good portion of his meal at shot time and a bit more from then to +3, by which time he has cleaned the bowl. Regs is not a big diver after his shot, but if he were, if he had a habit of doing that, you could slow down a dive by feeding a portion of his meal at shot time, and then feeding a bit each hour (+1 and +2, etc.).

Again, he's pretty flat, overall. I don't know that you need to do a lot of mini meals.

Here is something from Wendy that I have pasted into my ss to remember. It helps me a lot: [Look at] the +2 value compared to preshot value. If the values are about the same, it's a normal Lantus cycle with some downward movement. If the value of +2 is quite a bit lower [e.g., 20% lower], then it's a more active cycle and needs more attention paid. If the +2 is higher, it's a quiet cycle.

So what does that mean for you? If you'll look at 10/18 and 10/20, where he had a significant drop from preshot to +2, you'll see he had an active cycle. When you got the +2 test, you might have started feeding small amts. of LC food each hour to boost those numbers and keep him surfing and not dropping significantly (and of course you could adjust carbs based on how low the numbers go). But the numbers on 10/18 and 10/20 are truly not low numbers, so I wouldn't have done too much carb manipulation with them (just sort of like what we did a couple of nights ago, a bit to flatten him out and keep him from dropping below 90).

Jude is also 21 lbs.

 

[Staci & Ivy]

Wait, I need to feed Regs at +2 when the Lantus kicks in? I thought feeding him at shot time a big meal and giving him his lunch and nighttime snack was enough.
I am withholding food at least 2 hours before the shot, so at least I'm doing something right.
Maybe I should start splitting his main meals into smaller portions instead of giving him everything at once. Would that also help with those sudden drops he sometimes likes to surprise me with?

As for his weight, I don't really want him to lose much, I just don't want him to keep gaining. His brother is 21 lbs, but he's a big boy, and I really don't want little Regs to get there too

A small snack at +2, +3 or +4 (depending on when he drops ) are helpful to smooth the drops as the insulin onsets.
You could, just take some food from his main meal and reserve it for snack time. A few tablespoons is all you need.
Many of us use a timed feeder to dispense the snacks (if you are not able to do it manually).
They come with ice packs underneath and it keeps the food fresh.

 

[Britta and Regs]

A small snack at +2, +3 or +4 (depending on when he drops ) are helpful to smooth the drops as the insulin onsets.
You could, just take some food from his main meal and reserve it for snack time. A few tablespoons is all you need.
Many of us use a timed feeder to dispense the snacks (if you are not able to do it manually).
They come with ice packs underneath and it keeps the food fresh.

Thanks so much, Staci

I actually have this Petlibro feeder that's supposed to keep the food cold and has three little compartments, so that would work perfectly. Regs often leaves a little food in his bowl and comes back to finish it later anyway. Maybe I should make it part of his routine to get those last few bites/ half ounce from the feeder instead. That way he'd get his little snack around +2 without actually eating more overall.

I use the feeder for his night snack and at night he reacts on the bing it makes, not so good if I try to use it for his lunch. I guess I just need to get him used to the new day routine as well

 

[Britta and Regs]

You don't have to feed at +2. Feeding a meal at shot time is fine--that usually gives them the food they need for onset, which is typically around +2. That's what I do with Jude, who is a grazer, and eats a good portion of his meal at shot time and a bit more from then to +3, by which time he has cleaned the bowl. Regs is not a big diver after his shot, but if he were, if he had a habit of doing that, you could slow down a dive by feeding a portion of his meal at shot time, and then feeding a bit each hour (+1 and +2, etc.).

Again, he's pretty flat, overall. I don't know that you need to do a lot of mini meals.

Here is something from Wendy that I have pasted into my ss to remember. It helps me a lot: [Look at] the +2 value compared to preshot value. If the values are about the same, it's a normal Lantus cycle with some downward movement. If the value of +2 is quite a bit lower [e.g., 20% lower], then it's a more active cycle and needs more attention paid. If the +2 is higher, it's a quiet cycle.

So what does that mean for you? If you'll look at 10/18 and 10/20, where he had a significant drop from preshot to +2, you'll see he had an active cycle. When you got the +2 test, you might have started feeding small amts. of LC food each hour to boost those numbers and keep him surfing and not dropping significantly (and of course you could adjust carbs based on how low the numbers go). But the numbers on 10/18 and 10/20 are truly not low numbers, so I wouldn't have done too much carb manipulation with them (just sort of like what we did a couple of nights ago, a bit to flatten him out and keep him from dropping below 90).

Jude is also 21 lbs.

Thanks for explaining that, Mary! That makes much more sense now.

Regs actually sounds a little like Jude. He often leaves a little food in his bowl and comes back to finish it later. I also have a Petlibro feeder that keeps the food cold, so I was thinking I could start putting those last few bites/ maybe 0.5 oz or so in there and make a little snack around +2/+3 part of his routine. He already gets his nighttime snack from it, so I think he would adjust pretty well. It might help especially when I'm at work during the day.

And thank you for sharing Wendy's explanation about the +2 numbers. That's really helpful! I think I sometimes get so focused on how fast he's dropping that I forget the numbers themselves aren't actually that low. They just seem dangerously low to me because I'm so used to seeing 200s, 300s and 400s at night

So if the cycle seems more active, I could start feeding small amounts after +2 to help slow the drop? That makes sense. Maybe next time, which hopefully won't be tonight, I'll try giving him a teaspoon or two of LC food at a time. At what point would you switch to MC or HC? Under 100?

And how funny that Jude is 21 lbs too! He really doesn't look that big in his picture though!

I'm keeping my fingers crossed for a quiet night so I can hopefully increase Regs to 3 units tomorrow morning. I'm actually getting to the point where I'm a little disappointed when he gives me a pink number I guess that's some kind of progress too, considering how nervous I am about seeing lower numbers!

 

[Mary & Jude]

At what point would you switch to MC or HC? Under 100?

It's really hard to say at what point you would switch to a higher carb food. Basically, you switch when you need higher numbers and the LC isn't cutting it. But you kind of have to take it situation by situation. Go back to Feb 2025 on Jude's spreadsheet, and you'll see we went through a period of time where Jude went very quickly down the dosing ladder. It's a thing that can happen to kitties when their pancreas begins healing after staying in numbers below 100 for a good while (we call those pancreas-healing numbers). They take a lot of dose reductions quickly. Look at how I had to carb manipulate him in the remarks section--almost hourly--to keep him in safe numbers. I think you're beginning to understand food as a tool; you did really well the other night understanding that you needed to give him some carbs to keep him from going below 90. We call it surfing, because you really are kind of riding a food wave when you start carb manipulating--using the food to bump them up when necessary.

 

[Staci & Ivy]

Thanks so much, Staci

I actually have this Petlibro feeder that's supposed to keep the food cold and has three little compartments, so that would work perfectly. Regs often leaves a little food in his bowl and comes back to finish it later anyway. Maybe I should make it part of his routine to get those last few bites/ half ounce from the feeder instead. That way he'd get his little snack around +2 without actually eating more overall.

I use the feeder for his night snack and at night he reacts on the bing it makes, not so good if I try to use it for his lunch. I guess I just need to get him used to the new day routine as well

That’s a perfect plan!
I use the feeders for the +2 & +3 snacks for Ivy even though I’m mostly home. I just want her to be used to getting the snacks on her own (in case I have to be out).
She reliably goes and eats from her feeder.
It sounds like Regs already is used to the nighttime feeder, so it should work great!

 

[Britta and Regs]

It's really hard to say at what point you would switch to a higher carb food. Basically, you switch when you need higher numbers and the LC isn't cutting it. But you kind of have to take it situation by situation. Go back to Feb 2025 on Jude's spreadsheet, and you'll see we went through a period of time where Jude went very quickly down the dosing ladder. It's a thing that can happen to kitties when their pancreas begins healing after staying in numbers below 100 for a good while (we call those pancreas-healing numbers). They take a lot of dose reductions quickly. Look at how I had to carb manipulate him in the remarks section--almost hourly--to keep him in safe numbers. I think you're beginning to understand food as a tool; you did really well the other night understanding that you needed to give him some carbs to keep him from going below 90. We call it surfing, because you really are kind of riding a food wave when you start carb manipulating--using the food to bump them up when necessary.

Oh wow, Mary! I went back and looked at Jude's spreadsheet and I have to say, those numbers were terrifying and impressive at the same time! I can't imagine how nerve-wracking that must have been for you, especially having to manage his numbers with food so often.

I think I'm slowly starting to understand the whole concept of surfing, although I still have a lot to learn. I'm so used to seeing Regs in the 200s, 300s, and even 400s that anything approaching 150 still makes me nervous. Lets see if we get there today

Thank you so much for taking the time to explain all of this and for sharing your experience with Jude. It really helps me understand how food can be used as a tool rather than just something to feed him.

 

[Britta and Regs]

That’s a perfect plan!
I use the feeders for the +2 & +3 snacks for Ivy even though I’m mostly home. I just want her to be used to getting the snacks on her own (in case I have to be out).
She reliably goes and eats from her feeder.
It sounds like Regs already is used to the nighttime feeder, so it should work great!

Thats almost what I do, I always measure Regs at 4 am but I have the food in the feeder that he is getting used to it. Just in case I am out for a day or cant make it home on my lunch break. Or when we were on Vacation. During the day he has a little harder time reacting, so we need to work on that...