IloveLarry
Member Since 2014
thoughts on going to 1.5 u now? still a good idea? thanks
2/23 larry day 5 lantus AMPS 353 +3 250 +6 347 PMPS 321
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Suzanne & Cobb(GA)
Member Since 2013
Re: 2/23 larry day 5 lantus AMPS 353
I looked at your spreadsheet and you only gave 1.25units once, correct? I would have held it for longer than that to let Larry's body acclimate to the dose and see where it goes. I hold Cobb's doses for at least 4 cycles, and that is incredibly aggressive dosing.
Someone (I'm sorry I can't remember who) likens Lantus to a freight liner. It isn't going to bring the BG down immediately. Giving more at test time won't drop the number immediately.
Lantus is also based on the nadir, which usually happens between +5 and +7, not on the higher preshot number.
Since Larry is on Lantus, I'd invite you come and post on the Lantus TR board. There are a lot of experienced people there who can guide you on dosing and when to increase, etc. you may get more responses as well.
I looked at your spreadsheet and you only gave 1.25units once, correct? I would have held it for longer than that to let Larry's body acclimate to the dose and see where it goes. I hold Cobb's doses for at least 4 cycles, and that is incredibly aggressive dosing.
Someone (I'm sorry I can't remember who) likens Lantus to a freight liner. It isn't going to bring the BG down immediately. Giving more at test time won't drop the number immediately.
Lantus is also based on the nadir, which usually happens between +5 and +7, not on the higher preshot number.
Since Larry is on Lantus, I'd invite you come and post on the Lantus TR board. There are a lot of experienced people there who can guide you on dosing and when to increase, etc. you may get more responses as well.
IloveLarry
Member Since 2014
Re: 2/23 larry day 5 lantus AMPS 353
well this morning i gave the 1.5. the other day i believe 2 ppl agreed on it. he has stayed in the fushia since starting lantus. maybe stay with 1.5 awhile and see how it goes?
well this morning i gave the 1.5. the other day i believe 2 ppl agreed on it. he has stayed in the fushia since starting lantus. maybe stay with 1.5 awhile and see how it goes?
NitroViper
Member Since 2014
Re: 2/23 larry day 5 lantus AMPS 353
Im terribly new at this but looking at his numbers I would have stayed at 2.00 for a while because it never seemed to stay down. I don't use lantus so I don't know much about it.
What/when do you feed him?
Maybe consider trying a different insulin? I have no idea what I am talking about tho, just trying to get ideas
I read somewhere cats respond differently to different insulin's?
Im terribly new at this but looking at his numbers I would have stayed at 2.00 for a while because it never seemed to stay down. I don't use lantus so I don't know much about it.
What/when do you feed him?
Maybe consider trying a different insulin? I have no idea what I am talking about tho, just trying to get ideas
I read somewhere cats respond differently to different insulin's?
BJM
Member Since 2010
Re: 2/23 Larry day 5 Lantus AMPS 353
Lantus is a depot insulin which takes time to build up in the system. Dose increases should be made only AFTER a minimum of 3 full days on the dose (6 shot cycles).
If it has been over 3 full days AND mid-cycle/nadir values are over 150 mg/dL, you may increase 0.25 units.
See the Lantus TR forum stickie notes for more details; if nadirs are over 300, you can increase 0.5 as noted below.
Lantus is a depot insulin which takes time to build up in the system. Dose increases should be made only AFTER a minimum of 3 full days on the dose (6 shot cycles).
If it has been over 3 full days AND mid-cycle/nadir values are over 150 mg/dL, you may increase 0.25 units.
See the Lantus TR forum stickie notes for more details; if nadirs are over 300, you can increase 0.5 as noted below.
IloveLarry
Member Since 2014
Re: 2/23 larry day 5 lantus AMPS 353
gotcha. i went back and read and think i came to the same conclusion. i get it now. at least for now
gotcha. i went back and read and think i came to the same conclusion. i get it now. at least for now
IloveLarry
Member Since 2014
Re: 2/23 larry day 5 lantus AMPS 353 +3 250
plus3 250. progress! woohoo! maybe we will see blue at plus6
plus3 250. progress! woohoo! maybe we will see blue at plus6
Suzanne & Cobb(GA)
Member Since 2013
Re: 2/23 larry day 5 lantus AMPS 353 +3 250
Nice drop for the +3! Keep on sliding down Larry!!
Nice drop for the +3! Keep on sliding down Larry!!
Chris & China (GA)
Member Since 2013
Re: 2/23 larry day 5 lantus AMPS 353 +3 250
Hi Pam and Sugardude Larry!
First, let me explain about the different protocols for Lantus so you can decide which one is for you.
The Tight Regulation protocol that most of us use is an aggressive treatment which requires more careful monitoring, therefor more tests to keep the cat safe, as well as in better numbers. It's the only protocol that's been tested and published in veterinary journals as being able to get up to 84% of newly diagnosed diabetics OTJ (off the juice) within 6 months. Increases are done in .25 increments, and re-evaluated every 3-5 days (6-10 cycles). If the nadir (lowest point in the cycle) is still too high after 3-5 days, we increase the dose .25 unit and the "clock" starts over again, so you give the same dose another 3-5 days. It's important that you hold increases at least 3 days (6 cycles).
IF Larry were to go below 50 during any cycle, that would mean he's getting too much, and you'd REDUCE .25 and hold for another 6-10 cycles (unless he goes below 50 again!)
The "Relaxed" protocol (also called Start Low, Go Slow) isn't quite so aggressive, and therefore doesn't require quite as much testing (although BOTH protocols require at least 4 tests per day. The 2 Pre-shot tests, 1 test somewhere between +5 and +7 during the AM cycle, and a "before bed" test on the PM cycle.) On the SLGS protocol, doses are held for 7 days (14 cycles) before increasing. Decreases are done anytime the cat drops below 90 instead of 50.
Only you can decide which one works best for you and Larry, and no matter which you choose, we'll support and help you. If you decide that the SLGS protocol works best for you, you can still post where you are most comfortable..either in the Insulin support groups,(TR or Relaxed) or the Health board, but the insulin support groups are probably the best because you'll be hearing from experienced Lantus users.
You can also use the SLGS method and post in the TR protocol forum too! It's totally up to you. The TR forum is busier than the Relaxed forum, but no matter which, you'll get experienced people advising you. If you do decide the SLGL is better for you but want to post in the busier TR forum, just add SLGS to your signature so we know.
Please don't feel overwhelmed. We totally understand that there's a lot of information being thrown at you very quickly and that the learning curve here is steep! If there's something you don't understand, please say so and we'll keep working with you until you do understand it. If we're giving you too much information too fast, don't be afraid to say "Hey, slow down!!".
Sometimes we can come across as "pushy", but please understand we all just really want to help you and Larry, and sometimes our enthusiasm can come off the wrong way.
Most of all, we're here to help you to help Larry!!
Edited to add....No matter which protocol you use, it's really important to get some tests during that PM cycle. Most cats drop lower at night, and without that testing, we just can't know if his AM numbers are high because he needs more insulin, or they're high because he's bounced off of an unseen low number at night. Think of it like a puzzle...without ALL the pieces, it's really hard to see the picture.
Hi Pam and Sugardude Larry!
First, let me explain about the different protocols for Lantus so you can decide which one is for you.
The Tight Regulation protocol that most of us use is an aggressive treatment which requires more careful monitoring, therefor more tests to keep the cat safe, as well as in better numbers. It's the only protocol that's been tested and published in veterinary journals as being able to get up to 84% of newly diagnosed diabetics OTJ (off the juice) within 6 months. Increases are done in .25 increments, and re-evaluated every 3-5 days (6-10 cycles). If the nadir (lowest point in the cycle) is still too high after 3-5 days, we increase the dose .25 unit and the "clock" starts over again, so you give the same dose another 3-5 days. It's important that you hold increases at least 3 days (6 cycles).
IF Larry were to go below 50 during any cycle, that would mean he's getting too much, and you'd REDUCE .25 and hold for another 6-10 cycles (unless he goes below 50 again!)
The "Relaxed" protocol (also called Start Low, Go Slow) isn't quite so aggressive, and therefore doesn't require quite as much testing (although BOTH protocols require at least 4 tests per day. The 2 Pre-shot tests, 1 test somewhere between +5 and +7 during the AM cycle, and a "before bed" test on the PM cycle.) On the SLGS protocol, doses are held for 7 days (14 cycles) before increasing. Decreases are done anytime the cat drops below 90 instead of 50.
Only you can decide which one works best for you and Larry, and no matter which you choose, we'll support and help you. If you decide that the SLGS protocol works best for you, you can still post where you are most comfortable..either in the Insulin support groups,(TR or Relaxed) or the Health board, but the insulin support groups are probably the best because you'll be hearing from experienced Lantus users.
You can also use the SLGS method and post in the TR protocol forum too! It's totally up to you. The TR forum is busier than the Relaxed forum, but no matter which, you'll get experienced people advising you. If you do decide the SLGL is better for you but want to post in the busier TR forum, just add SLGS to your signature so we know.
Please don't feel overwhelmed. We totally understand that there's a lot of information being thrown at you very quickly and that the learning curve here is steep! If there's something you don't understand, please say so and we'll keep working with you until you do understand it. If we're giving you too much information too fast, don't be afraid to say "Hey, slow down!!".
Sometimes we can come across as "pushy", but please understand we all just really want to help you and Larry, and sometimes our enthusiasm can come off the wrong way.
Most of all, we're here to help you to help Larry!!
Edited to add....No matter which protocol you use, it's really important to get some tests during that PM cycle. Most cats drop lower at night, and without that testing, we just can't know if his AM numbers are high because he needs more insulin, or they're high because he's bounced off of an unseen low number at night. Think of it like a puzzle...without ALL the pieces, it's really hard to see the picture.
KPassa
Member Since 2012
Re: 2/23 larry day 5 lantus AMPS 353 +3 250
The reason Mel and I suggested going from 1u to 1.5u is because of this from the TR Protocol:
The reason Mel and I suggested going from 1u to 1.5u is because of this from the TR Protocol:
It is up to what you feel most comfortable with increasing. If you want to increase to 1.25u first, that's fine, but you might not see much movement with the numbers and will have to wait 3 days/6 cycles before increasing to 1.5u again.
IloveLarry
Member Since 2014
ty all good ppl! for all ur help.
i think today is finally going btr. looks like some decent results only time will tell if we have to go up to 2.0.
had company pop over yesterday. what a treat.
i think today is finally going btr. looks like some decent results
only time will tell if we have to go up to 2.0.had company pop over yesterday. what a treat.
IloveLarry
Member Since 2014
oh, and those of u who mentioned why we did the increase....i remembered the reason aftr i askd..u know how that goes? as soon as u ask....u know? well it goes 10 fold for my feeble brain.
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