2/10 GracieD AMPS-149, +1-410, +2.5-341

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Jason & Belle (GA)

Jason & Belle (GA)

Member Since 2010
https://spreadsheets.google.com/ccc?key ... v7sO#gid=0

Hey folks,

Gracie started Lantus on Saturday at 1u. As you can see from the spreadsheet, her PS numbers were very high, but she had a good dip in the duration. Yesterday, I knew she was ready for an increase. I shot 2u last night, and immediately had reservations. She did her normal drop, so at +6 I went to sleep. This morning, her PS was 149.

I don't want to skip a dose since she may be gaining some momentum, and my goal is remission ASAP, but if she has anything close to her normal dip after shot, any dose could be problematic.

Thoughts?

Edit: Her shot time is 9EST, so we are :30 late at this point. Shot .5u at 10AM and her +1 was 410. This is typical of her preshot numbers, but it came 2 hours later with the 2u dose. Hopefully the .5u I shot this morning will kick in +2. Will likely shoot 1.25u or 1.5u tonight. Update: Looks like the .5 kicked in and she's down to 341.

Thanks,

Jason
 
Re: 2/10 GracieD AMPS 149 - Dose Question

you have 3 options when presented with a lower than usual preshot number:

* Stall -- do NOT feed and retest in 15 - 30 min. You want to repeat this until you see that numbers are rising or you have a solid surf. The downside is that it may throw your schedule off since you will need to test 12 hours from whenever you eventually shoot.
* Shoot a BCS (big chicken sh*t) dose. This is a reduced dose.
* Skip the shot completely.

will you be home to monitor today?
do you have a supply of canned high carb food to control the curve if gracie's numbers drop too low?


keep in mind, no matter what dose you shoot this morning it will have the effects of the 2u dose given last night working with it.
 
Re: 2/10 GracieD AMPS 149 - Dose Question

I tested her about :30 later and she was at 159, but she did eat. I have no problem shooting low numbers, but my concern is the significant drop she's been having after the shots. My other cat was always fairly predictable, but Gracie is not. I will be around to test, but these big, significant drops worry me. She has dropped up to 160 in 3 hours on 1u, so I'm leaning towards .5u.

Jason



Jill & Alex said:
you have 3 options when presented with a lower than usual preshot number:

* Stall -- do NOT feed and retest in 15 - 30 min. You want to repeat this until you see that numbers are rising or you have a solid surf. The downside is that it may throw your schedule off since you will need to test 12 hours from whenever you eventually shoot.
* Shoot a BCS (big chicken sh*t) dose. This is a reduced dose.
* Skip the shot completely.

will you be home to monitor today?
do you have a supply of canned high carb food to control the curve if gracie's numbers drop too low?


keep in mind, no matter what dose you shoot this morning it will have the effects of the 2u dose given last night working with it.
Click to expand...
 
Re: 2/10 GracieD AMPS 149 - Dose Question

shooting 0.5u this morning is fine.
fwiw, my suggestion is to shoot 1.25u tonight and hold the dose for at least 6 cycles (unless gracie drops too low) as suggested in the tight regulation protocol. taking the dose up gradually is much better than increasing in large increments with lantus.

STICKY: LANTUS & LEVEMIR - TIGHT REGULATION PROTOCOL: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581
 
Re: 2/10 GracieD AMPS 149 - Dose Question

I was immediately sorry I gave her the 2u. I'll keep a close eye on her today and make the incremental increase tonight if the numbers are ok.

Thanks for your input,

Jason

Jill & Alex said:
shooting 0.5u this morning is fine.
fwiw, my suggestion is to shoot 1.25u tonight and hold the dose for at least 6 cycles (unless gracie drops too low) as suggested in the tight regulation protocol. taking the dose up gradually is much better than increasing in large increments with lantus.

STICKY: LANTUS & LEVEMIR - TIGHT REGULATION PROTOCOL: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581
Click to expand...
 
Re: 2/10 GracieD AMPS 149 - Dose Question

i understand how difficult it is to go against vet advice, but we do have an impressive track record here in the lantus isg. you might want to take a look at our master spreadsheet list. if you click on the "OTJ" tab at the top, you'll see the spreadsheets of kitties who have gone OTJ following the tight regulation protocol.
here's the link: http://spreadsheets.google.com/pub?key=pZ1soNpOWRCB5WKzukx_dHQ
 
Re: 2/10 GracieD AMPS 149 - Dose Question

This board was great for my cat Belle, and that's why I came back for Gracie and wanted her on Lantus. I'll continue to keep my vet informed, but follow the advice on this board since it's plentiful and readily available.

Thanks again,

Jason

Jill & Alex said:
i understand how difficult it is to go against vet advice, but we do have an impressive track record here in the lantus isg. you might want to take a look at our master spreadsheet list. if you click on the "OTJ" tab at the top, you'll see the spreadsheets of kitties who have gone OTJ following the tight regulation protocol.
here's the link: http://spreadsheets.google.com/pub?key=pZ1soNpOWRCB5WKzukx_dHQ
Click to expand...
 
Re: 2/10 GracieD AMPS 149 - Dose Question

Great to hear back from you and I'm sorry that Gracie is needing insulin.

I agree with Jill -- it's hard to not defer to your vet, especially one that's a feline specialist. I use a cat-only vet as well. She's great and she does her best to stay on top of the field. However, while she knew that Lantus has an admirable track record for getting cats into remission, she wasn't familiar with the Tight Regulation Protocol until I sent it to her. Maybe one way to think about the advice your vet gave you isn't that you're ignoring her input, you may get to 2.0u, you'll just get there more slowly. It sounds like she's more familiar with using PZI than Lantus -- and that's OK. She can't be an expert in everything. You've got good support and resources here.
 
Re: 2/10 GracieD AMPS 149 - Dose Question

I completely sympathize with your situation. My prior vet basically showed me the door after I refused to drop Willie from 1.5 units twice a day to 1 unit once a day because he went into the greens, and she believed allowing cats into double digits was "killing" them. And this was one of the "best" cat only practices in town. Our current vet isn't thrilled with the approach, but is at least willing to let me be, even if I test "waaayyyy too much." LOL

You've hit the nail on the head, though. Ultimately you have to follow your gut and do what you feel is best for Gracie. Hopefully your vet will be open-minded and will use your experience with Gracie as a learning experience in how Lantus works.

Good luck to you guys... you are doing great, and are in GREAT hands here!
 
Re: 2/10 GracieD AMPS 149 - Dose Question

Thanks for the support. As you can see, she bounced to 410 at +1. If nothing else, I learned that Gracie has a definitive point where the Lantus wears off and is likely variable by dose. On 1u, the Lantus wore off and her numbers shot up for the PS, with 2u, it happened two hours after shot time. That extra two to 3 hours of action is likely what allowed her BG's to drop more than usual. Once I find the sweet spot, we'll be golden.

Jason

Christie & Willie said:
I completely sympathize with your situation. My prior vet basically showed me the door after I refused to drop Willie from 1.5 units twice a day to 1 unit once a day because he went into the greens, and she believed allowing cats into double digits was "killing" them. And this was one of the "best" cat only practices in town. Our current vet isn't thrilled with the approach, but is at least willing to let me be, even if I test "waaayyyy too much." LOL

You've hit the nail on the head, though. Ultimately you have to follow your gut and do what you feel is best for Gracie. Hopefully your vet will be open-minded and will use your experience with Gracie as a learning experience in how Lantus works.

Good luck to you guys... you are doing great, and are in GREAT hands here!
Click to expand...
 
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