11/13 Tubby, new lantus patient!!!

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Shawny2u

Member Since 2010
Sorry folks, I was away and missed a lot of responses. Let me first by saying thank you all, you are being more than generous and I will read
every entry by tomorrow and respond accordingly. I am told the spreadsheet finally is in order (I haven't seen it myself as of yet) but that is a good news. Maybe now I can express my thoughts and Tubby's situation better than before. I started this new topic based on one of the member's suggestion even though I honestly don't know how things are suppose to work here. I hope new topic is the way to go, I will be updating Tubby's spreadsheet sometime in the morning as I have started his new dose knowing there are disagreements with the increase. I will be very interested to read opinions on why adding an extra unit is too much also would love to see some data to support that system of thoughts. I will be studying the "Lantus stickie" or "storage shed stickie" to become more informed as it seems everyone here talks about them.
Let me conclude by saying it would be a pleasure to engage in a constructive exchange of opinions to find better ways to help our kitties.
Thank you all!

Here is the latest Tubby's BGL :

11/13 Tubby AMPS 331 +2 340 +4 297 +6.5 263 +8 324 +12 PMPS 334 2 units injected at 8:19 pm Day 8th
See you in the morning!
 
definitely read the stickies. There you will find the protocol we use and the research that supports it.

You wanted data that exhibits why we do not recommend increases in increments of 1 unit. Look at Lucy's spreadsheet in my signature (look at June 08). Nothing, nothing, nothing, no significant response no matter what the dose. Her lowest number on 4 units was 175 and I really wanted to increase by 0.5 units. I thought "she's on a higher dose, that's not a big % increase, it will be fine." The fine folks here said no, she might be nearing her breakthrough dose, please only increase by 0.25 units. So I went to 4.25. On the 6th cycle of 4.25, all of a sudden she was in the 50s. No gradual lowering of the numbers, no easing into blue first, just green (low green) out of nowhere. Two days after that she was in the 40s. I'm SO glad I didn't do a 0.5 increase then!

It does worry me when people increase by a whole unit at a time, because I have seen how much difference 0.25 can make, even on a cat with a higher dose. You could bypass the correct dose without even knowing it, and that can lead to a pattern of numbers just getting higher and higher as the cat's systems have to fight the insulin.

Another suggestion is each time someone posts to you, look at their spreadsheet. Especially if they have been here a little while, you will probably see the same pattern of nothing, nothing, nothing, EVERYTHING on their spreadsheets too. There are exceptions. Some newly diagnosed cats' spreadsheets don't look the same. Some are different for other reasons (my other cat, Jazzy, has acromegaly so her spreadsheet doesn't look like other cats'.). Most do have that pattern, though.
 
I thought the SS was in order as I was told but evidently is not working due to some technical problems. I have no choice but to post Tubby's test results
manually here until SS is fixed. I do apologize for the inconvenience, also didn't have enough time to respond yet. That is my top priority as soon as
time allows.


11/13 Tubby AMPS 331 +2 340 +4 297 +6.5 263 +8 324
11/13 PMPS 334 2units
11/14 +6 297
11/14 AMPS 324 2units +3 276 +5 327 +6 340
11/14 PMPS 299 2units
 
If your dose is 1unit and you increase to 2units, you have DOUBLED the dose which is not the safe way to go.

The protocol works and even I follow the general guidelines for the most part, even though Oliver's dose is 18.5units and Shadoe's is 8.25units.
A great many cats have gone OTJ by following the protocol, when using Lantus or Levemir, so the proof you want is on the spreadsheets of those who no longer need insulin.
Below is from the protocol:

"General" Guidelines:

--- Hold the initial starting dose for 5 - 7 days (10 - 14 cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 cycles).

--- Each subsequent dose is held for a minimum of 3 days (6 cycles) unless kitty earns a reduction (See: Reducing the dose...).

--- Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.


Increasing the dose...
--- Hold the dose for 3 - 5 days (6 - 10 cycles) if nadirs are less than 200 before increasing the dose.

--- After 3 consecutive days (6 cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.

--- After 3 consecutive days (6 cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.


Reducing the dose...
--- If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.

--- If an attempted reduction fails, go right back up to the last good dose.

--- Try to go from 0.25u to 0.1u before stopping insulin completely.

Random Notes...
Because of the cumulative nature of Lantus and Levemir:
An early shot = a dose increase.
A late shot = a dose reduction.

A "cycle" refers to the period of time between shots. There are 2 cycles in one day when shooting twice a day.

Sometimes a dose will need to be "fine tuned" by adding some "fat" or "skinny-ing up" the dose.
 
Good evening!
I'm trying to read and digest everything carefully before making any comments. I must admit there are many valid points with demonstration of factual
practice of Lantus utilization. I need more time and research to fully comprehend the complexity of this insulin. I hope with your generous contribution
and exchange of available data my current confusion on some of the issues I raised previously turn me into a more productive member of Lantus family.
please note your generosity is greatly appreciated! I believe the SS is in working condition as far as I know, if otherwise or I might be doing something
unconventional with it please let me know.

Thank you all kindly,
Shawn
 
Shawny2u said:
Good evening!
I'm trying to read and digest everything carefully before making any comments. I must admit there are many valid points with demonstration of factual
practice of Lantus utilization. I need more time and research to fully comprehend the complexity of this insulin. I hope with your generous contribution
and exchange of available data my current confusion on some of the issues I raised previously turn me into a more productive member of Lantus family.
please note your generosity is greatly appreciated! I believe the SS is in working condition as far as I know, if otherwise or I might be doing something
unconventional with it please let me know.

Thank you all kindly,
Shawn
Click to expand...

I think the best way to comprehend and understand how Lantus works is to post often and read other people's condo's (threads) as we call them. You can really learn quite a bit on how to treat Tubby by how others here use Lantus.

We welcome you to join our family and post often and ask questions. We are here to help. :mrgreen:
 
Thanks Miriam,
I do intend to read as much as they become available to me, posting is a different story. I will be posting Tubby's
BGL numbers on the spreadsheet to good people here on this thread.
His numbers will signify his progress or lack of. I'm hoping to make progress!
I was carefully looking at the fluctuation of his blood glucose from the first day he was on insulin, if you look
closely its clear 2 units of Lantus at its best nadir is way above 300. I hear so much about 0.25 unit raise,
for many reasons. The question is what are the compromises if 0.25 raise take months if not year or years to bring
your kitty's blood sugar to a safe range. It's not just the diabetes you are dealing with, its the whole range of
serious deadly diseases we're talking about if blood sugar is not controlled in time. We are talking about watching
cat suffers from heart, kidney, liver, ..and list goes on as a result of diabetes lingering too long because you are
worried of over dosing. High blood pressure, hyper thyroid, cardiomyopathy, lung failure, ..you name it.
You can be careful of dosing with no danger or consequences of over dosing but what about putting your
cat at the mercy of what the long term high blood sugar can cause? How many people have lost their cats
during or even after their cat was in remission? has anyone ever thought why their little furry died untimely?
And what was the reason of their death? I bet 9 of 10, they were related to some kind of organ failure.
Please don't be shy and tell me if I'm talking gibberish!
I do command the scientific approach to control the Bg without dangering you cat of hypoglycemia .,
which we are all well aware of, but that is not the only issue at hand. You take my word for it, I've seen
the consequences of long term feline diabetes.
Now let me make quite clear, I'm not suggesting by any means that you shoot your cat with insulin
rampantly until his BG is leveled. What I'm saying is there is more to careful 0.25 unit at the time than
your cat health in general. And may I ask everyone here to take a look at Tubby's chart, is there anyone
here can seriously question one unit raise just because it didn't follow the protocol?
If so I'll be more than happy to talk about it.
I won't get into the philosophy of what some of you said regarding the dosing and cycles unless
one is interested but I would like to discuss Tubby's numbers with the current dosage and
what I think the next dose should be by the end of next cycle?

Shawn
 
Welcome to LL. Glad you got your SS working.

One comment - you'll need to get some overnight data to make sure the dose you're using isn't causing Tubby to drop low overnight then compensate the next day with higher numbers. High numbers can be a result of too much insulin as well as not enough. By increasing too quickly you may go past the optimum dose and it's very difficult to troubleshoot that after the fact.
 
That's about the only thing I can add, I'm no scientist, but did go thru the sugar dance and the importance of evening checks - you are really missing half your information there with Tubby - science or no science, a lot can happen in the evening cycles.

Keeping Tubby safe in BOTH cycles is about as important as it gets ;-)
After all, you do shoot insulin twice a day...make sense?
Think about it k?
 
Your ss is only half the picture. Without numbers to show how the pm shots are working, not much can be said.

Cats go lower overnite, so those pm tests are needed. There are many morns that I get up early to test because one of mine may have gone low overnite. The most important test you can do in the eve is the before-bed test. You don't want to know how many people had sleepless nites because they had to stay up to bring up their cat's numbers. Cats go lower at nite, so you may be seeing higher during the day because of it.

As for doubling a dose, I can't say that it is safe. Yes, I do see the 300s, but those numbers would have called for a .5u increase, but not a full 1u increase. That's a 100% increase. If you follow your pattern, the next increase you would give Tubby would be up to 4u, but I am sure you would not do that, right?

With Lantus and Lev, there is a shed involved, and you need to be sure that shed is full before you will see the full effect of a dose. One of mine can take more than 6 cycles before I see some change, but the other may react in 4 cycles. If I get high numbers, I may consider a 1u increase, but when the dose you are giving is 18u or 8u, that 1u increase is not that big of a %increase.
Aggressive dose changes are usually later on, when you are already giving a higher dose, but even then, it's iffy. There's always that shed to fill, and sometimes it overflows.

You are also dealing with more than just numbers, and you can't force a body to produce numbers you want by too much insulin. If you test one morning and see a very low number, what is your plan? If you jump too far ahead and it's too much, how much do you cut back? Talk about causing stress on the cat, that jumping forward then backwards, searching for the ideal dose would be very hard on the cat.

If you see any searches, say for a lost child, how is the search conducted? Slowly and orderly, step by step, yes?
You are doing the same thing; you are searching for Tubby's ideal dose, and the protocol WILL find it for you, provided you follow it, slowly and orderly.

It is very hard to be patient when new, but that patience is what will see you and Tubby to that perfect dose in the most timely manner.
Following the protocol will not steer you wrong, and it will also ease Tubby into the needed dose.
 
Shawn & Tubby said:
Please don't be shy and tell me if I'm talking gibberish!
Click to expand...
You're talking gibberish. The consequences of high BG do not occur overnight. In the absence of any other medical problem, it takes years of uncontrolled or poorly controlled diabetes to result in organ damage. If you read the protocol thoroughly, you can raise doses after 4 - 6 cycles (2 - 3 days). No cat is going to stay in excessively high numbers for very long. Further, while the long term effects of FD are not trivial, the effects of overdosing your cat are immediate and potentially fatal.

I can think of one instance here of a cat remaining in high numbers where we urged the person to get their cat to a vet. Those concerns were disregarded with a resulting sad outcome. Other cats, who's doses are being carefully raised and remain in higher numbers, are tested for high dose conditions or infections or inflammation (such as dental disease) are ruled out. The people here are not insensitive to the concern of a cat being in numbers above renal threshold. However, we have seen the results of an overdose and we do not sit idly by while you panic. People will stay up with you for as long as it takes to make sure your cat is safe. With Lantus, an overdose can mean upwards of 16 hours of constant monitoring. The effects of someone overdosing their cat take a large emotional toll on this community and it is a situation we are encouraging you to avoid given you are using a dosing strategy that is based on insufficient data. For as much as you say you embrace a science based approach, you are basing your dosing on something other than scientific principles. You really can't have insist on science and then say it doesn't apply to your cat.

We follow a protocol that has established science behind it. It has been published in a respected veterinary journal. Again, if you take the time to read the links in the Tight Regulation sticky, the Rand/Queensland protocol is available and the references to the publications are provided in the introduction. What everyone is telling you isn't based on gut feeling or group think. It's based on clinical trials. It's up to you whether you want to take advantage of the information that we are providing along with the experience of the people here.
 
Tubby's numbers are way above even close to acceptable numbers at this point. and I disagree with
statement regarding organs. My cat is suffering from such problems and his current BGL could be
fatal. Please note his +6 BG number tonight.......
 
Hi there,
Just curious but what are your plans with regard to dosing today? I am not sure what you meant by looking at the +6; are you saying that is a bad number so you must increase or it's a good number and will hold the 2u? That 287 is just above renal threshold, not way above. That 287 is by far certainly NOT fatal!

With what part of the organ statements do you disagree?

As has been said, if you are not dealing with any other medical issues with medications that can muddy the picture, and you have no Xrays or ultrasounds to show health issues and organ damage, or some other proof, I think the organ statements as presented are fair.

Do you have some bloodwork test results that indicate some organ failures? Maybe we do not have all the info, so your concern looks unjustified. If you have some other data that you have not mentioned, could you please post the details?

If at all possible, pm testing needs to be added onto your ss because of cats' having a tendency of going lower overnite. Without the other half of the picture, it's hard to suggest what dose may be suitable.
I did notice a couple days where your +6 was higher than your pmps; those numbers reminded me of my Oliver who has a very late nadir. Your cat may have a later nadir, so that's why it's important to test at different times along a cycle. My Shadoe may be lowest at +4 or +5 and then she starts with higher BG numbers.

Aside from your numbers, how is Tubby acting? You need to look at the whole cat because numbers are NOT the first thing to show change. In the beginning, you will see faster changes in urination and appetite and general attitude. Those are the improvements you will start to see way way way before you see the numbers improving.

Because most people have no idea how long their cats have been diabetic, it's possible that it will be harder to get results.
If a person throws their back out, and does nothing about it, pretty soon the pain stops and the wrong place becomes the right place. When you go to get the back realigned, it's highly likely that you will have to go back a few times because your back will say WHOA that is wrong! and the back will slip out into the wrong place quickly. I know this to be true, speaking from my own experience.

Now, for Tubby, he's grown accustomed to those numbers. Yes, they are bad, but Tubby likes them so tough for you. Think of a polar bear swim... that water is COLD! Your giving him insulin is forcing him into that icy water, and his body/ liver says WHOA too cold! and scoots back up to the high numbers. You need to be more gentle and don't shock Tubby.

You can't force his body to give you nice numbers... not gonna happen. The protocol works, but dose changes need to be based on the whole picture, so you will need to get more data for the pm side of the picture.

The protocol states to hold for 6cycles / 3 days, then adjust the dose based on nadir levels. Would you be following those guidelines, I would guess the increase to 2.25u would fit, but better to see what the experts have to say. They may say you could try the .5u increase to 2.5u dose.

Be gentle with Tubby and you will have a happier, healthier kitty.

To know the road ahead, ask the man coming back ..... cuz he's been where you are now and knows.
 
If you want to increase, you can increase Tubby's dose to 2.25u. You've been at this dose for 8 cycles. If you read the protocol, you can increase after 6 cycles:

"General" Guidelines:

* Hold the initial starting dose for 5 - 7 days (10 - 14 cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 cycles).

* Each subsequent dose is held for a minimum of 3 days (6 cycles) unless kitty earns a reduction (See: Reducing the dose...).

* Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.


Increasing the dose...

* Hold the dose for 3 - 5 days (6 - 10 cycles) if nadirs are less than 200 before increasing the dose.

* After 3 consecutive days (6 cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.

* After 3 consecutive days (6 cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Click to expand...

Organ damage does not occur overnight, in a week or two, ore even in the span of a few months. Some disorders are more prevalent with age. FD may accelerate the problem but it may not be the cause of the problem. I hope you are not getting your information from some of the FD websites that tend to use scare tactics. Having your cat diagnosed with FD is hard and scary enough. You don't need to be subjected to information that will sweep your feet out from under you and cause you to overreact and overdose your cat. Do some reading about the complications of diabetes in humans. It's a reasonable model for your cat. The timeline involved with the complications of diabetes may be shorter in a cat (given their shorter lifespan and faster metabolism) but there are very few problems that cause spontaneous organ failure.
 
Shawny2u said:
Tubby's numbers are way above even close to acceptable numbers at this point. and I disagree with
statement regarding organs. My cat is suffering from such problems and his current BGL could be
fatal. Please note his +6 BG number tonight.......
Click to expand...

Shawn, please LISTEN and accept the advice you are getting here. The combined knowledge of the experts on this FDMB by FAR outweigh any other group of people on this planet (and that includes Veterinarians). That is why you are here in the first place, is it not? Unless your cat has some life-threatening or pre-existing condition, or DKA or something, then normally, the risks of insulin overdose by FAR outweigh the risks of insulin under-dose (or even no insulin at all).

These folks have been through this more times than I have had hot dinners - and they know FROM EXPERIENCE, of what they speak. They are not just making it up or regurgitating what they have read somewhere, they LIVE it - over and over, every day and every year.

OK at the end of the day it is your decision what you do with your cat - but PLEASE do realize, for all the folks the folks on here, their first and only thoughts are for the safety and well-being of your cat. There just are no shortcuts and no flying blind (not even for the overnight hours, when most normal people are sleeping!)

Final thought: FD does not take the night off - so neither can we...
 
Shawny2u said:
and I disagree with statement regarding organs. My cat is suffering from such problems and his current BGL could be fatal.
Click to expand...
Can you please cite the source(s) for your two assertions? And elaborate on the problems your cat is suffering from?

There is an old saying on this board: "better too high for a day, than too low for a minute." If you insist on an aggressive dosing approach, please educate yourself on the symptoms, treatment and consequences of hypoglycemia. Your cat's life could depend on this. How to treat HYPOS - THEY CAN KILL! Print this Out!!
 
Shawny2u said:
Tubby's numbers are way above even close to acceptable numbers at this point. and I disagree with
statement regarding organs. My cat is suffering from such problems and his current BGL could be
fatal. Please note his +6 BG number tonight.......
Click to expand...


Unless there are other medical issues involved, you are over-reacting to your cat's situation and will cause more harm to your cat than help.

Please, please listen to these very experienced feline diabetic care givers. Read the stickies they have provided you, read the protocol...it is tried, tested, and true.

It has since been published in the Journal of Feline Medicine and Surgery. http://www.tillydiabetes.net/en_6_protocol2.htm

It is going to take some time for your cat's insulin shed to be filled. Going off half cocked and overdosing your cat because of your impatience will KILL Tubby. Yes, KILL Tubby in the wink of an eye.

Go look at my spreadsheet from 11/15/10. You will see a "flash drop at +4" in blood glucose level. A quarter of a unit did that. A lousy stinking 0.25u increase. See those crazy freaky 500+ numbers a few days ahead of it....warnings about a dose potentially too high.

LISTEN TO THESE FOLKS. Don't let your impatience to see improvement KILL your cat.
 
Blue said:
Shawny2u said:
Tubby's numbers are way above even close to acceptable numbers at this point. and I disagree with
statement regarding organs. My cat is suffering from such problems and his current BGL could be
fatal. Please note his +6 BG number tonight.......
Click to expand...


Unless there are other medical issues involved, you are over-reacting to your cat's situation and will cause more harm to your cat than help.

Please, please listen to these very experienced feline diabetic care givers. Read the stickies they have provided you, read the protocol...it is tried, tested, and true.

It has since been published in the Journal of Feline Medicine and Surgery. http://www.tillydiabetes.net/en_6_protocol2.htm

It is going to take some time for your cat's insulin shed to be filled. Going off half cocked and overdosing your cat because of your impatience will KILL Tubby. Yes, KILL Tubby in the wink of an eye.

Go look at my spreadsheet from 11/15/10. You will see a "flash drop at +4" in blood glucose level. A quarter of a unit did that. A lousy stinking 0.25u increase. See those crazy freaky 500+ numbers a few days ahead of it....warnings about a dose potentially too high.

LISTEN TO THESE FOLKS. Don't let your impatience to see improvement KILL your cat.
Click to expand...

Yes there are other medical issues involved. I have posted his medical history before, it seems to me no one has seen it. Tubby is suffering from hyperthyroid and cardiomyopathy. He is on Methimazole,Benazipril, and Lasix. I even asked in that posting the details will be given if there was any interest but I have never received any replies. These illnesses are the results of his 2006 diabetes, I have no doubt. I was asked repeatedly about PSPM spot check, that at night his numbers may drop lower than day time. If you check his SS you will notice the last couple of nights I tried to do that at his nadir or close to that time frame. The numbers speak for themselves. I'm not here to question this board's expertise on lantus or any other issues regarding feline diabetes as someone suggested. I'm here only for one purpose and that is to listen carefully to what is said and apply that toward helping Tubby so his problems are more controlled. However I do consult with number of other experts and my personal experience of his behavior in the past. Aggressive or not which is the matter of opinions, his BGL has not budged any so far. My question to experts here is simple: How many cycles it takes to see some kind of movements either way? Tubby has been on lantus close to two weeks and his BG is as high as before insulin treatment. To answer those who are suggesting with dosing scale I use such as "what would be the next dose? 4 units?" I simply say no absolutely not. The next dose will be carefully calculated with regards to inputs I receive here and other sources that are available to me. You can be sure no one involved in his well being has any intention of harming him by rampant dosing!! I hope that my bold response or disagreement of certain issues would not cause any reason or discouragement to anyone from extending their valuable inputs which I do hold highly with utmost respect and appreciation.
The truth of the matter is, your generous involvements and concerns for tubby's best has tremendous effect on my discussions and decisions on the next move.
Once again I do thank every and each one of you for your perseverance in staying around and sharing your valuable experience and knowledge!!

Best regards,
Shawn & Tubby
 
My question to experts here is simple: How many cycles it takes to see some kind of movement either way? Tubby has been on lantus close to two weeks and his BG is as high as before insulin treatment. To answer those who are suggesting with my scale "what would the next dose? 4 units?"
Click to expand...


Then you have not read the protocol or appear to refuse to follow it? We can't help you if we don't know what you are doing or you won't share your "other sources."

Based on the protocol Tubby should be well into phase 2:
Hold each dose for 5-7 days. However, if the cat is producing continuously high BGs (nadir always >=300 mg/dl), only hold the dose for 2-3 days before increasing it by 0.5 IU. Alternatively, if the cat is continuously producing moderately elevated BGs (nadir always >=200 mg/dl), increase the dose every 2-3 days by 0.25 IU

Now ...the other half of this question the answer is Every Cat Is Different (ECID). And that is true for any insulin you may attempt to use.
 
Shawny2u said:
Yes there are other medical issues involved. I have posted his medical history before, it seems to me no one has seen it. Tubby is suffering from hyperthyroid and cardiomyopathy. He is on Methimazole,Benazipril, and Lasix. I even asked in that posting the details will be given if there was any interest but I have never received any replies. These illnesses are the results of his 2006 diabetes, I have no doubt.
Click to expand...

Let's take a step back for a second here.
Shawn, I am sorry you don't feel like ppl were listening. It would help if you could post a profile in your signature (there are instructions in the tech forum), so that ppl can access Tubby's history. There are a lot of cats here and it's almost impossible to remember everyone's medical history and current medications. In addition, though many of us might have some experience with pancreatitis, hepatic lipidosis, CRF, and neuropathy... the less common things like cardiomyopathy... there are fewer people who are going to chime in b/c of inexperience. Please do not take it personally or as dis-interest in the well-being of Tubby.


Shawny2u said:
I was asked repeatedly about PSPM spot check, that at night his numbers may drop lower than day time. If you check his SS you will notice the last couple of nights I tried to do that at his nadir or close to that time frame. The numbers speak for themselves. I'm not here to question this board's expertise on lantus or any other issues regarding feline diabetes as someone suggested. I'm here only for one purpose and that is to listen carefully to what is said and apply that toward helping Tubby so his problems are more controlled. However I do consult with number of other experts and my personal experience of his behavior in the past. Aggressive or not which is the matter of opinions, his BGL has not budged any so far.
Click to expand...

It can be quite frustrating, but it's also hard to see the improvement if you don't know what you're looking for. Are you testing for ketones on a regular basis? that is important too. (we ask this info in the profile. I'm sorry if you've answered before, but I am no longer a regular poster here as my cat has gone to the bridge.) In addition, you can learn a lot from reading other condos.

By the way. Can you do a new condo every day to update? it's really important so that everyone can get more familiar with you and Tubby. That's just the way this place has worked for a looong time.

Shawny2u said:
My question to experts here is simple: How many cycles it takes to see some kind of movements either way? Tubby has been on lantus close to two weeks and his BG is as high as before insulin treatment. To answer those who are suggesting with dosing scale I use such as "what would be the next dose? 4 units?" I simply say no absolutely not. The next dose will be carefully calculated with regards to inputs I receive here and other sources that are available to me.
Click to expand...

no one is questioning your love for Tubby. But we do strongly advocate for the 'start low, go slow' motto here to make sure we find the right dose for each cat in a methodical manner. Unless there are extenuating circumstances (for example: acromegaly, IAA, or ketone prone kitty), we increase by 0.25units at a time. We hold the first dose for 5-7 days (10-14 cycles), then you can increase every 3-5 days, depending on numbers.

Shawny2u said:
You can be sure no one involved in his well being has any intention of harming him by rampant dosing!! I hope that my bold response or disagreement of certain issues would not cause any reason or discouragement to anyone from extending their valuable inputs which I do hold highly with utmost respect and appreciation.
The truth of the matter is, your generous involvements and concerns for tubby's best has tremendous effect on my discussions and decisions on the next move.
Once again I do thank every and each one of you for your perseverance in staying around and sharing your valuable experience and knowledge!!
Shawn & Tubby
Click to expand...

Good luck to you and Tubby. This board saved my cat's life and gave me precious precious time with him. Our best time. I hope the same for you and Tubby.
 
Hello, Shawn, and welcome!

You can see that everyone wants to help you and Tubby. There is so much information to exchange -- we are trying to learn about Tubby, just as you are learning from the "stickys."

Please try to be patient. You are getting wonderful feedback here.

- Create your Google profile, so that everyone can read Tubby's medical history. People here are very knowledgeable. They have seen a wide range of conditions in many cats.
- As Sienne said, the protocol suggests a .25 dose increase now. You can feel better about moving Tubby in a methodical, scientific way toward the best dose.
- Look at some of the other spreadsheets. You will feel better about where Tubby is right now.
- Please trust that the dangers of raising the dose too quickly are great. If this new dose doesn't work, you can raise it by .25 after another 3-5 days.

My Kitty is an example of a cat whose dose was raised so quickly that his "correct" dose was missed. Because of that, the insulin didn't appear to work, and the vet kept raising the dose. I almost lost him because of too HIGH a dose -- not too LOW a dose.

THIS FORUM SAVED MY CAT'S LIFE. They showed me how to start over at a lower dose, and gradually work up to the right dose, where Kitty's diabetes started to respond to insulin. It took months, and I worried about the organ damage.

But as of today, my Kitty has been in remission for seven months. ( flip_cat )

I trust the people in this forum completely. You are in the right place!
 
Could someone name a few syringes with lower dosing scales that are economical? Currently I'm using
BD 3/10 cc 30 units from CVS. They come in a bag of 10 syringes for about $3.00
I am on my last and must buy some for tomorrow's PM shot. Would be nice to know what most
people use to get more precise dose on smaller scales.

Thank you in advance!
 
You can find inexpensive syringes at Walmart. I just bought a box of Relion 100 syringes for around $12.

Ask for the 3/10 cc units 31 gauge with Half Unit Marks/scale


The Half Unit Marks are important if you intend to follow the 0.25 or 0.5 unit dose changes.
 
I don't buy by the bag, but rather I buy up all the boxes I can find of the ones you are using.
My costs are of no matter as I am in Canada and I don't buy anything online.
I am always worried of running out, so I have about 5 full boxes right now.

If you could attach a profile and spreadsheet in a signature, all the important info about your cat will be known by any person who reads any message you post. You can click on the links in my signature and in any other poster's signature to get an idea of what people are providing for others.

I can relate to your concerns about other health issues, as my two both with acromegaly, and one also to be needing further testing relating to cardiomyopathy and possible asthma. It's vital for this info to be placed in my signature so that others who read any posting I make will understand what to consider when looking at my BG numbers and dosing and meds. Acro means my cats have functioning pancreas and their diabetes is likely a result from acromegaly, so my issues are different from yours with Tubby having a less than fully functional pancreas.

All that being said, I followed the protocol for my cats and it works. Today, my Shadoe got 10u and my Oliver got 19u this morning. They have acromegaly and require LARGE amounts of insulin BUT I worked my way up to those numbers by following the protocol.
If nadirs are between 200 and 300, I went up .25u. If above 300, up .5u.
I know that Shadoe takes about 4cycles to fill her shed and realize any increase, Oliver sometimes takes 6cycles or more.
I quite often need to be more aggressive because they are acro, but that`s another discussion. Having acro in my signature is usually enough for others to know that we sometimes need to veer from the protocol.

If you are seeing 300s for 6 cycles, increase by the .5u, then hold for 6 more cycles. If nadirs below 300, you will need to have the half unit markings on whatever syringes that you get.
 
Thank you all for listening and participating. I did buy a bag of 10 syringes, 3/10 cc with 30 units but they have 10 lines in every 5 units.
I suppose that means they are with 1/2 unit markers.
Tubby's numbers are moving south for the first time and I'll be monitoring him tonight, I am excited yet it's to early to pass a judgement.
The numbers will be posted as I go along, hopefully someone is watching as it might approach the normal range sometime soon. My wild guess
would be in the next few days but again its just my hunch.
 
The spreadsheet's looking great; I am sure you and others will now be able to easily see how Tubby is reacting to a dose and other things.
What you can do this morning is to start a new thread, using the subject 11/20 Tubby AMPS - ###

That way people will know that the info is current and can follow better.
All you need now is a profile with the info on Tubby's health issues and the meds you are giving for them.
Look at some other people's profiles to get an idea of data to include like age, sex, diet, health issues, medications, etc.
 
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