27/Jan/2019 - Calvin - should I change dose?

[Jess]

Hi all, this is my first post. Calvin started on 2u of lantus twice a day. He eats low carb wet food only. My vet is lovely but she likes to suggest raising his dose whenever there is a high number, doesn't like home testing and would prefer I didn't provide any part unit doses (I have been using the pen).

Hopefully I've attached his chart in my signature correctly. It has been recommended I test lowering his dose by 0.25u to see if that helps reduce the bounce. I'm a little nervous about changing to syringes but happy to do whatever is best for him.

Just interested in other thoughts..

https://docs.google.com/spreadsheet...YRZ7yRG-yhAtYpgj2zCYBNZNI9M/edit?usp=drivesdk

 

[Wendy&Neko]

Hello and welcome. I am glad you've ignored the vet's suggestion not to test. And to raise his dose in response to a high number. As you've discovered, cats can bounce in response to numbers lower than they are used to, and we use the lowest numbers primarily as the method to determine when and how much to change the dose.

You might want to read over our two dosing methods here, the Tight Regulation protocol and the Start Low Go Slow Method. There are Sticky Notes describing each. If you follow one of those, you will have a proven dosing method to follow, and you don't need to ask the vet for help every time a dose needs to be changed.

The answer to whether or not to change the dose is tricky. If you were following TR protocol, the answer would be no. If following SLGS, the answer would be yes. TR has a reduction point of 50 on the human meter and SLGS has a reduction point of 90, and he has gone below 90. TR is a more aggressive dosing method, but with that comes a need for a bit more testing than you are doing now. In addition to the preshots, it is suggested you get a second test each and every cycle. However, that doesn't work with everyone's lifestyle, so it's best to chose a dosing method that works for you.

Bounces are not a bad thing. It means his body protection system is working and it also means the insulin is getting his body into numbers he's not used to yet. Over time and as they get used to normal numbers, the bounces can fade away, though the timing depends on the cat.

Using a syringe is actually quite easy. There is a video on how to use the pens or vials with a syringe in the Syringe and Insulin Info Sticky Note.

 

[Jess]

Thanks for your reply.

Unfortunately with my work hours I am unable to test much more than I do, particularly after the AM shot - so SLGS might be a better option for me.

 

[Wendy&Neko]

In that case, I agree with the reduction to 0.75 units. There are pictures of drawing those fine doses, again in the Sticky Notes. Good luck with the new dose.

 

[Jess]

I'm a little confused about how to draw 0.75u even after reading all the info :-S I have u-100 0.3ml syringes - no half markings because I haven't been able to find them here.

Please let me know if I should be posting this somewhere else.

 

[Wendy&Neko]

Sorry, missed the part about you being in Oz. I presume you are using the BD syringes? There is a ruler here, that can be used with the BD's. Directions and pictures how to use the ruler are in a document attached to the Sticky Note on Tight Regulation called Management of Diabetic Cats.

 

[Jess]

Sorry, missed the part about you being in Oz. I presume you are using the BD syringes? There is a ruler here, that can be used with the BD's. Directions and pictures how to use the ruler are in a document attached to the Sticky Note on Tight Regulation called Management of Diabetic Cats.

Sorry, I only just saw this as the notification went into my junk folder. Is that image to help do part doses using the BD syringe? The 1u line still means 1u yeah? (Such as the pic attached?)

 

[Wendy&Neko]

Yes, the ruler is to be used with the BD syringes. I can't see the line numbers on your picture, but there is the zero line, then the 1 unit line, if your syringes don't have half unit markings.