11/14 Pino AMPS 533 +2 441 +4 405

It looks like you increased by 0.25 units today. Keep that dose for at least six cycles to build the depot and see how 2.5 units is working.

Welcome to the Lantus/Levemir/Biosimilars forum. When people sign up, we ask them to post to the Feline Health forum first, but it looks like you've got things set up already. Could you tell us a bit more about how you found out Pino was diabetic, any other health issues, and what you were doing for dosing before you came here?

I see he had DKA at diagnosis, it is good to see you are testing regularly for ketones.

One other thing you'll have to do is decide which of our two dosing methods you'd like to follow. Once you've decided that, please put TR (Tight Regulation) or SLGS (Start Low Go Slow) in your signature, so we can help you with dosing. More information on the dosing methods here:
Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR) With both dosing methods, you would only do a 0.25 unit increase if you are seeing nadirs under 300.
 
History:
Pino was diagnosed with diabetes in late August. He was a healthy kitty till then. He started to lose weight and to act strange (lethargic) after the death of my grandma that passed away in July. After that me and then my parents went for a holiday for a week. When I came back from holiday i noticed he was not the same. Then I took him to the vet and she diagnosed him with DKA and diabetes. He was in hospital for 5 days and came out with Lantus 2units/12h. He had Libre sensor (that is why i don't have so much readings because it stayed on the device that was from the vet). The vet called me every 5-6 days and advised me to increase the dose gradually for 1 unit (from to 3 units, then 4 and now 5 units). When he came home from the hospital he was like before, playfull and satisfied but with high BGs. Till the beggining of October when he went back to not being OK. He again started to not eat all day, vomit and begin to hide under the bed. I took him immediately to the vet and she diagnosed him with pancreatitis (at that time we were on the 5 units of Lantus /12h). He stayed in the hospital again for 4 days and they said that maybe it is too much insulin for him. When i came to pick him up the vet said they tried to lower the dose but they ended up again on 5 units of Lantus. He came home on 19th of October and since then I really try to monitor the BGs as often as I can.

He is now doing really fine except he is hungry all the time and has these numbers that go up and down. I really like my vet because they saved my kitty but i was constantly asking her if it is okay for him to get so much insulin (because I work at the hospital and have seen people that have diabetes). At the last check up the vet said to raise the dose on 6 units /12h. I tried one night but then i was scared of the hipos and got back to 5 units.
With help of the group i bought the 0.3ml syringes and gradually tried to decrise the dose with the goal to find the right one that will work for us.

I feed my kitty with Animondo Carny and Wild freedom wet food. I give him food everytime when he gets shoot and then around +4 and +8.
 
Higher numbers make them hungry and thirsty. The decrease from 2.5U to 2U on 8/11 may have been too much. We usually decrease in multiples of 0.25U at doses below 5U. Since he is on a low carb canned diet and you are testing quite a bit, you might want to follow TR. Especially with a history of DKA. It will help you get to a good dose faster and hold a dose that enables him to spend more time in normal numbers (50-100 mg/dl or 2.8 to 5.5 mmol/L).

Ariana said:
I feed my kitty with Animondo Carny and Wild freedom wet food. I give him food everytime when he gets shoot and then around +4 and +8.
Click to expand...
In case you haven't seen it. I'm sharing the low carb food list for UK and EU:
https://docs.google.com/spreadsheets/d/1J5JpMe6TDXrHq_aTl9hUtHy6Gs9oRBqlz4nPGKxtySA/pubhtml
 
I will keep the dose until tomorrow and do the curve after tomorrows PMPS.

Based on the numbers and TR protocol (nadirs greater than 300) should i increase for 0.5u after curve if needed?
Really scared of these high numbers
 
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Considering his history of DKA and the fact that you took unearned reductions per TR (even though you weren't following any particular protocol then), you could probably increase to 2.75U tomorrow itself. He has been over 300 for the last 4 days.

Going to tag @Wendy&Neko for confirmation. Increase by 0.25U or 0.5U? And as early as tomorrow?
 
If you are following TR, you can increase by 0.5 units if you aren't seeing anything under 300. I also agree with Bhooma that you can increase tomorrow, as those numbers you last got on 3.0 units did not earn a reduction. I'd call it going back to the last good dose.
 
Wendy&Neko said:
If you are following TR, you can increase by 0.5 units if you aren't seeing anything under 300. I also agree with Bhooma that you can increase tomorrow, as those numbers you last got on 3.0 units did not earn a reduction. I'd call it going back to the last good dose.
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I will check BG today through the day and if needed increase it at the PMPS because i just saw your message.
 
Let's give it 6 cycles on this dose :-)

A small housekeeping note - we request members to post a new thread for a new day. This ensures that the thread doesn't get too long to read. We also ask that you link your previous post to the current post - just paste the URL of your previous post in the body of your current post saying "Previous Post"
 
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