11/17 Rocky AMPS 233 +1 275 +2 281 +3 228 +4 255 +5 272 +6 198 +7 301 +8 282 +9 173 +10

Jen & Rocky

Jen & Rocky

Member Since 2020
Hi all,

I'm new here and this is my first time posting. Glad to be here :)

Quick question- my sugar cat, Rocky, came out of remission recently and has just switched from ProZinc to Lantus for the past 6 days. We currently have him fitted with a Freestyle Libre Monitor so we've been able to get readings mostly every hour.

In the past 6 days, he's had two hypoglycemic events. The first one was on Day 2 of starting Lantus. We gave him 1.5 units because his numbers were in the 300s all day leading up to his PM shot which was 317. At the time, we didn't know not to raise the dose the first 7 days.

The other hypoglycemic event occurred last night after giving him 1 unit (his pre-shot number was 237). He didn't eat his usual amount with the shot so we suspect that had something to do with it.

According to the spreadsheet, it looks like he dips lower at night than in the morning on the same amount of insulin (1 unit). I think I read somewhere that this is fairly typical?

Do you think it's safer to only give him .5 units at night instead of 1 unit?

His spreadsheet is linked in my signature.

Thanks in advance!
Jennifer
 
I tried accessing your spreadsheet, but I don't have the permissions to look at it. That's the first thing I do when someone asks about dosing, is to open the spreadsheet.

In general with Lantus, we try to find a dose where you can give the same dose in the AM and PM. Without seeing the data, I can't suggest what that would be.
 
Hi Wendy,

Sorry, I just updated the permissions on the spreadsheet so you probably have access now. Would be great to have your input if you don't mind taking a look:) Thanks!
 
Thanks, I can see it now. :) I am going to ask you a favour, and ask that you clear any information out of the U (units) cells that isn't a dose. It just makes it too hard to see. If you need, you can create an additional column before the U column to contain the time of the shot, or anything else you want. It would also declutter if you put food details in the Remarks section. You can put a "*" or something like that in the +BG column if you have extra notes and want to note when you fed. We also don't need to see the exact time of tests. But you can round it to something like @4.5 as an example, for +4.5.

Here we determine how to change the dose of Lantus based on how low the dose takes the cat. That means sticking to the same dose for several days, unless a reduction is earned. That 36 you got early on was telling you to be patient and not increase for that higher PMPS. It takes 5-7 days for the depot to build, so you have to try to ignore any high numbers until then.

A couple more questions, what does it mean "Libre and AT alternating"? Is the data you have from the Libre only? Did you buy an chance double check the low numbers with the AT? I've heard it recommended that you double check Libre lows with a manual test.

Bottom line, because of that 44, which I'm going to assume is valid without backup testing by the AT, I'd suggest you lower the dose to 0.75 units day and night and see if you can go for a while with that.

If you haven't already, I recommend reading the yellow starred Sticky Notes at the top of this forum. One thing people will want to know early on is if you are planning on following one of our dosing methods, and if so, which one. It'll help us give dosing suggestions if we know which method you want to follow.

And yes, many cats go lower at night. Unless they don't. :cat:
 
I meant to add, good notes in the Remarks about what you fed during the lows. The goal when feeding lows is to bump them up about 30-40 points. You might want to adjust the quantities for next time. :p First, karo is usually dispensed in terms of drops, not tsps. Second, when feeding a low, you don't want to stuff them, in case the carbs wear off and you have to get them to eat again. Usually a couple tsps of HC is a good start. And toss the dry food if you can!

Do you know which proteins he reacts to? Neko couldn't handle the wheat in Fancy Feast gravy lovers, so I got some of the Weruva Grandma's Chicken Soup (21% carbs), and some of the Cats in the Kitchen pouches that are 16-17%. They use potatoes for carbs instead of wheat. If all else, you can add a drop or two of karo to his regular LC to make high carb food.

I noticed your notes on the budesonide reduction. Neko went down to 0.75 mg and that worked for her. She got it as liquid, so it was easy for me to adjust the amounts.
 
Thanks so much Wendy! Appreciate you taking a look and responding so quickly! I will clean up the SS right now:) I took a look at your spreadsheet. I can definitely see the difference in terms of quickly spotting the numbers!

"Libre and AT alternating" just means that we will be using either the Libre monitor OR the AT to get daily readings. He *hates* manual readings with the AT so we thought we'd keep getting him fitted with a Libre monitor if that's feasible and if not, then we'll get his readings with the AT. We didn't manual test the two low numbers with the AT because we were panicked and just wanted to 'fix' him as quickly as possible.

Makes sense to lower the dose to .75 units morning and night. In terms of dosing methods, are you asking if we plan to implement the Go Slow, Start Low method and move toward tight regulation... or something else? Sorry, this is all quite new to me :)

And thanks for the info on how to handle a hypo crisis. I was told to give a tsp of Karo and LC wet food but it totally makes sense to give regular HC wet food to start. Panicky mom here I suppose :p And thanks for the suggestions on the HC food too. Not sure which proteins he reacts to, but I like the Weruva brand so we'll stock up on some of those. Yes, we will toss the dry food.

In terms of Budesonide, Rocky takes a compounded chew so it's been easy to cut in half. Actually, we're trying to titrate him off of Budesonide altogether. Next week, he will start Chlorambucil (chemo drug) for his IBD. We'll have to get him fitted with a new Libre monitor so we can see how it interacts with his diabetes.

I just watched Neko's tribute video. I'm over here in tears. What a beautiful tribute. I'm so sorry for your loss :(
 
People here use either the Start Low Go Slow Method or the Tight Regulation protocol for dosing. Just pick whatever best suits your lifestyle and goals. And if you decide later you want to switch, that's OK too. But the too have you hold doses for different lengths of time and have different reduction points, so it's good to know which you'd like to follow, then put either TR or SLGS in your signature.

Is Rocky's IBD quite severe? Usually chlorambucil is only given for small cell lymphoma or extreme IBD. It's a chemo drug so you only want to give it if necessary, and only with a modern dosing protocol. IBD is usually controlled with diet and probiotics. You'd try that before chemo. And I'd much rather give budesnoide than chlorambucil - done that one now for three cats. I've given Visbiome probiotic which is specially for IBD. If you haven't already, I'd consider a consult with an internal medicine vet since you are dealing with multiple issues.

Neko was my best teacher and a great cat, miss her.
 
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