3/2 Ashfur AMPS 344 - Question about dosage

ASHFUR

ASHFUR

Member Since 2021
HI all,

I updated my spreadsheet for the past week. We increased last 2/25/21 ONLY his PM dose to 2 in order to match his AM dose (HIS vet had me doing 2 different quantities). I posted here and learned doses should always be the same 2X daily (thanks for that). He has been on the same 2.0 Am dose since 2/13/21

My new question is I would like to increase his dose (Lantus) to 2.25 this Thursday (will have been exactly 1 week since last adjustment). Given the spreadsheet data can anyone tell me if they would do the same? One of the big reasons I would like to do it is because I have 5 days off in a row Thurs through Monday and I can be home to monitor him.

Also, I have a freestyle Libre on him currently but purchased a blood meter. If this libre comes off. how often do I need to check his BG? pre-shot? What's a normal amount to check? I suppose if you just did a dose increase you would want to be checking frequently, but if not then is there a need to check more than pre-shot and +6?

I am emailing the vet today but I wanted to get opinion here because I feel like the more feedback I can get the better.

Thanks for taking the time out of your day to help me on this.
I'm still learning as I go, and I appreciate everyone's support.

-Kristi

He is currently 13.6 lbs (I bought a scale finally) he has been eating fancy feast classics at insulin times and DM kibble. I hope to get him on wet food all the time but I leave both out when I go to work and he usually eats the dry.

previous post: Changing Kitty Dosage? Why would we keep it the same if numbers are still high? Lantus | Feline Diabetes Message Board - FDMB
 
Last edited:
Hello there! Do you have a previous post around here somewhere? I'm just taking a tiny break from work, so I don't have time to look for it...if you could copy and paste it into your condo, that would be great!

Also, in order to get more eyes on your post it would be best to format your title like this:

3/2 Ashfur AMPS ### - Question about dosage.

And finally, what dosing method are you using? And at the top of your SS, it says Libre - so all the test results so far are downloaded from the Libre, correct?

If you're on TR an increase would certainly be in order - after 6 cycles (3 days without seeing any better numbers than this, you can increase)...however on SLGS a few more days - I think up to 7 days or 14 cycles before changing the dose...

I think you'll get more opinions and advice by changing your title as soon as you can and then adding to your signature some info about your kitty - the only thing I see there now is the SS...
 
Ok ill copy and paste it into my post. I dont know how to edit the actual title. I dont have the option. Maybe I could repost.....

Does the #### stand for the AM preshot nunber for today?

And how do I know what type of method I should be using? I would assume it is the go slow method because my vet is reluctant to change doses even after a few weeks of bad numbers. However after doing my own research I saw that dose increases can happen after 7-10 days so that is why I decided to increase him this coming Thursday (IF) he continues to have the same results. This Thurs will be exactly 7 days from the past increase.
 
Hi and welcome to you and Ashfur, also on the west coast (Seattle)! i'm still too new to give advice but wanted to say hi because your Ashfur's s/s colors are a lot like Minnie's and I can relate to your story a bit.

She was diagnosed last April and monitored with the Libre until I started here last month after a hospital stay DKA when the vet had us transitioning from Lantus to Levemir, and they said no more Libre due to increasing allergic reaction to the adhesive. I did the same as you and retyped a few days of Libre data into the spreadsheet. I downloaded all the previous Libre reports from the Libreview website and posted a link in my signature, though to be honest I don't know if it has been any use to anyone.

Everyone says this and I will repeat.
1) You are in the right place here. So much knowledge, so many smart and helpful people and quick responses! (not like waiting for the vet)
2) There is a TON of info here and it will probably take a while before it sinks in and you understand it

It's only after a month that my brain is beginning to absorb it. I was just doing what the vet told me until last week when I finally understood what TR was, after reading this sticky I don't know how many times. About halfway down there are dosing instructions which helped me understand the science part, but I would always ask for advice here before making changes. I finally went rogue and did the increases to 4u and 4.25u without consulting the vet and - ta-da! finally seeing some progress at 4.25u for Minnie.

Regarding food, I removed the Rx kibble completely after about 3 days on this board. Minnie was also on DM Selects which I stopped last week because it's just over 10% and switched to DM pate at 5% + trying out some other non Rx foods but she's being picky. Somebody has probably pointed you to this post from the main forum but here it is again just in case. There are pdf, excel and online versions of the food chart.
https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/

and this is good reading https://catinfo.org/

Sorry for the essay. Even more for you to read! Promise it gets easier.
 
Hi Kristi,

Since you're still feeding Ashfur dry food, you would need to stay with the Start Low Go Slow (SLGS) protocol, which requires you to stay with a dose for 7 days and then a curve is done with tests every 2-3 hours to ascertain whether the dose needs to be changed. There is a sticky about it on the forum that you can find here: Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)

When I started on this journey I did SLGS because my Ruby was also eating dry DM kibbles. Once I stopped that, her BG levels did go down and I was able to start the Tight Regulation (TR) protocol, which quickly lead to more blue and green numbers in the healthy range.

Once the Libre comes off, it will be good to have a MINIMUM of 4 tests a day, one before each shot and at least one midday and one before bed test. When your kitty goes into lower numbers (below 200) you will have to test more in order to keep him safe. I'm doing TR, and if you look at Ruby's spreadsheet, I try to get at least three or four tests between her AM shot and PM shot, and at least two before I go to bed. Some here test a lot more than I do. It's whatever you can manage. I like having the information.

Please keep asking questions! We're here to help. :)
 
Liz & Minnie said:
Hi and welcome to you and Ashfur, also on the west coast (Seattle)! i'm still too new to give advice but wanted to say hi because your Ashfur's s/s colors are a lot like Minnie's and I can relate to your story a bit.

She was diagnosed last April and monitored with the Libre until I started here last month after a hospital stay DKA when the vet had us transitioning from Lantus to Levemir, and they said no more Libre due to increasing allergic reaction to the adhesive. I did the same as you and retyped a few days of Libre data into the spreadsheet. I downloaded all the previous Libre reports from the Libreview website and posted a link in my signature, though to be honest I don't know if it has been any use to anyone.

Everyone says this and I will repeat.
1) You are in the right place here. So much knowledge, so many smart and helpful people and quick responses! (not like waiting for the vet)
2) There is a TON of info here and it will probably take a while before it sinks in and you understand it

It's only after a month that my brain is beginning to absorb it. I was just doing what the vet told me until last week when I finally understood what TR was, after reading this sticky I don't know how many times. About halfway down there are dosing instructions which helped me understand the science part, but I would always ask for advice here before making changes. I finally went rogue and did the increases to 4u and 4.25u without consulting the vet and - ta-da! finally seeing some progress at 4.25u for Minnie.

Regarding food, I removed the Rx kibble completely after about 3 days on this board. Minnie was also on DM Selects which I stopped last week because it's just over 10% and switched to DM pate at 5% + trying out some other non Rx foods but she's being picky. Somebody has probably pointed you to this post from the main forum but here it is again just in case. There are pdf, excel and online versions of the food chart.
https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/

and this is good reading https://catinfo.org/

Sorry for the essay. Even more for you to read! Promise it gets easier.
Click to expand...


Wow thank you for that! It helps me so much to hear about your journey. Can I ask you how you feed wet food at night? Or does your cat just eat during the day. Ive noticed my cat eats more food over night than during the day and I think its because during the day Im giving him wet food 3x and all night im asleep. My husband is up until 3am though so I could potentially feed him over night also or is that not nesessary? He eats wet food (pate only) if I add water but he licks the juices and leaves alot of the bits behind. I bought a small food processer and it made it into a soup and he turned his nose up to it. Ive purchased so many different low carb wet foods and he seems to like fancy feast the best. Id love to get him on that and only that but I just dont know how much he needs to be fed (if that is all he is getting).
 
PerfumedCatMom said:
Hi Kristi,

Since you're still feeding Ashfur dry food, you would need to stay with the Start Low Go Slow (SLGS) protocol, which requires you to stay with a dose for 7 days and then a curve is done with tests every 2-3 hours to ascertain whether the dose needs to be changed. There is a sticky about it on the forum that you can find here: Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)

When I started on this journey I did SLGS because my Ruby was also eating dry DM kibbles. Once I stopped that, her BG levels did go down and I was able to start the Tight Regulation (TR) protocol, which quickly lead to more blue and green numbers in the healthy range.

Once the Libre comes off, it will be good to have a MINIMUM of 4 tests a day, one before each shot and at least one midday and one before bed test. When your kitty goes into lower numbers (below 200) you will have to test more in order to keep him safe. I'm doing TR, and if you look at Ruby's spreadsheet, I try to get at least three or four tests between her AM shot and PM shot, and at least two before I go to bed. Some here test a lot more than I do. It's whatever you can manage. I like having the information.

Please keep asking questions! We're here to help. :)
Click to expand...

Did you stop suddenly? How did that process go and what is your feeding schedule now?
 
ASHFUR said:
Did you stop suddenly? How did that process go and what is your feeding schedule now?
Click to expand...
Once Ruby was diagnosed with diabetes, I was using the DM dry food as a topper, so she didn't get more than a tablespoon a day. I did eventually buy microchipped feeders for my two cats and the civvie still eats a bit of dry but Ruby eats only wet now. I went kind of cold turkey on taking away the dry after many people here advised me against it. I was also only feeding her twice a day, letting her graze on wet food but again after getting some advice here I break up her meals into three meals in the day before +6 and three meals at night, last one served before I go to bed. So if I was feeding her two 3 oz cans of Fancy Feast a day, instead of feeding her one can all in one go at shot time, I feed her 1 oz at shot time, 1 oz at +2, and 1 oz at +4 (I have a digital kitchen scale to measure out portions). The logic here is that the smaller meals are easier on her stomach and pancreas (Ruby no longer vomits, hairballs or otherwise, unless it's a symptom of some other issue she has, and there are many), and I am able to "feed the curve". Lantus usually kicks in around +2 and it can cause a pretty steep drop in numbers, so I feed her at shot time and then at onset around +2 or +3, and then again around +4 or +6. The insulin starts wearing off after +6, so feeding after this time puts the brakes on it, which you don't want to do. Another reason to break up the meals is so that in case the cat drops quickly from the insulin, you can keep him hungry so you can feed him honey or high carb to keep him from going dangerously low.

Here is a great condo on "feeding the curve": https://www.felinediabetes.com/FDMB/threads/8-10-tashie-pmps-high-questions.101989/#post-1087990

Thankfully Ruby is usually a good eater (she's been having some appetite issues recently), and I time her feedings right after I do her BG tests so that she now associates testing with a nice meal after. She jumps up onto the couch to be tested and purrs while I rub her head and ears with the warm sock before I prick her, and then we eat. :cat:

If you're concerned about feeding him at night, many people here use automatic feeders like the Petmate. They're also great for when you might have to work outside the home during the day and want to feed small meals or if the cat is running low you can leave medium or high carb food for them to munch on while you're away so they can stay safe.
 
Very helpful information for me. Right now I do his shots at 9:45 and he eats about 1/2 of the 3oz can. Then I feed him before I go to work at 2:30pm. I dont get home until 9:30pm. So Im gone for the last half of his cycle. Which is why I leave dry food out. Ive left wet before but when I get home its still there untouched.
Maybe if the dry food is gone he wont have the option and he will eat what I leave....Ill have to try some things out on my days off.
Thank you
 
Yes on the dose increase to 2.25 units. With SLGS, the goal is to get the nadirs, or low points, between 90 and 149.

Multiple small meals is easier on the healing pancreas. Over time you will learn the best time to feed him, once you've learned how carb sensitive he is and his patterns on Lantus. The goal is to try get to nice slow gentle curves and food can be part of that.
 
Got it. We are so Far away from that number but Im starting to feel a little less overwhelmed. He is a dry food addict so it might take some time to get him adjusted on wet alone.
Now can I just verify that if I did take away his kibble I wouldn't do it following a dose increase correct? Do we treat that the same wait time? For example if I take away kibble I would need to wait a week and see his curve before doing any dose adjustments?
 
Nice job on the title!! :)

ASHFUR said:
Now can I just verify that if I did take away his kibble I wouldn't do it following a dose increase correct? Do we treat that the same wait time? For example if I take away kibble I would need to wait a week and see his curve before doing any dose adjustments?
Click to expand...

Removing dry food can have an impact on BG numbers - so be watchful when you do that, as you might need to decrease the insulin.

When you talk about the 'wait time' that depends on which dosing method you're on - TR is a shorter wait time, SLGS is a longer wait time...and of course be watchful of the low BG numbers; On SLGS the cut off for a reduction is 90, on TR it's 50...so you'll want to study up on the dosing method you're following and make your increases based on the recommendations of that particular dosing method...

Hope that helps :)

Have a great evening!
 
ASHFUR said:
Very helpful information for me. Right now I do his shots at 9:45 and he eats about 1/2 of the 3oz can. Then I feed him before I go to work at 2:30pm. I dont get home until 9:30pm. So Im gone for the last half of his cycle. Which is why I leave dry food out. Ive left wet before but when I get home its still there untouched.
Maybe if the dry food is gone he wont have the option and he will eat what I leave....Ill have to try some things out on my days off.
Thank you
Click to expand...
I find cats to be incredibly resilient, a vestige of their time as desert survivors. :) They might whine and complain but they adjust. Good luck and keep us posted!
 
Sue and Luci said:
Nice job on the title!! :)



Removing dry food can have an impact on BG numbers - so be watchful when you do that, as you might need to decrease the insulin.

When you talk about the 'wait time' that depends on which dosing method you're on - TR is a shorter wait time, SLGS is a longer wait time...and of course be watchful of the low BG numbers; On SLGS the cut off for a reduction is 90, on TR it's 50...so you'll want to study up on the dosing method you're following and make your increases based on the recommendations of that particular dosing method...

Hope that helps :)

Have a great evening!
Click to expand...


Im going to ask a question that is going to probably sound like I need to do more research but I tried to find the answer and could not. Why would one chose one method over the other. Is there a rule of thumb? Do people choose one method and just stick with it for the long haul? It gives me info on both but how am I to know which is best? Sorry Im going to re-visit the sticky again and read. Im just trying to get an understanding of wether Im on the right method? They are both very different so there must be a reason you would go with one versus the other.
 
ASHFUR said:
Can I ask you how you feed wet food at night? Or does your cat just eat during the day. Ive noticed my cat eats more food over night than during the day and I think its because during the day Im giving him wet food 3x and all night im asleep. My husband is up until 3am though so I could potentially feed him over night also or is that not nesessary? He eats wet food (pate only) if I add water but he licks the juices and leaves alot of the bits behind. I bought a small food processer and it made it into a soup and he turned his nose up to it. Ive purchased so many different low carb wet foods and he seems to like fancy feast the best. Id love to get him on that and only that but I just dont know how much he needs to be fed (if that is all he is getting).
Click to expand...

I don't feed her at night, but I'm a night owl so I give her something at bedtime which is around midnight then she wakes me 6ish.

I did buy a Petsafe 5-meal Automatic Feeder which seems the most popular here (also debating some glass bowls which someone here recommended). Catmate also gets good reviews. You can freeze the food or catmate comes with an ice block so it's fresh at feeding time.

I used to only feed twice a day until about 10 days ago, again on advice here. I was worried about another DKA and was advised to give her more frequent smaller meals and add water..

Good for you he likes pate only! Pate tends to have lower carbs, keep away from gravy.
 
One important reason why some people follow SLGS is they can't get their cat off dry food. Because we can't reliably predict the effect of dry food on a cat's blood sugar levels, it's harder to be guiding with food with dry in the picture. There are also a lot of people who would not be able to be around because of work or family or just life and can't handle the testing and feeding of a low number situation. That being said, many here have done TR with a full time job.

TR worked for me because I'm at home because of the pandemic and because I wanted to get Ruby on a track towards remission. She may or may not get there, but right now she is well regulated and I credit that to this group. It can be fairly exhausting physically (because of lack of sleep) and emotionally (fear of lime green numbers) but you can usually find someone here to hold your hand during those times and you'll be fine. If you can test and keep dry food out of the picture, TR is the way to go.
 
ASHFUR said:
Why would one chose one method over the other.
Click to expand...

I didn't even understand the difference when I started, just followed the instructions from my vet until I had an epiphany and realized it matched up to TR. Then I did the increases to 4u and 4.25u under guidance from this team.

PerfumedCatMom said:
It can be fairly exhausting physically (because of lack of sleep) and emotionally (fear of lime green numbers) but you can usually find someone here to hold your hand during those times and you'll be fine.
Click to expand...
COMPLETELY AGREE! Time consuming to do all the testing, but I'm also at home and desperate to get her numbers under control (or at least under 300) after 3 hospital stays since diagnosis in April. However there was no choice for me between doing this and worrying about another DKA. Mind you, I was only using dry food as a treat so that wasn't a factor for me.

@Bandit's Mom has been a complete saviour for me. :bighug: She's in Mumbai so the time difference has worked perfectly to have her on hand during my night time crises!
 
ASHFUR said:
Im going to ask a question that is going to probably sound like I need to do more research but I tried to find the answer and could not. Why would one chose one method over the other. Is there a rule of thumb? Do people choose one method and just stick with it for the long haul? It gives me info on both but how am I to know which is best? Sorry Im going to re-visit the sticky again and read. Im just trying to get an understanding of wether Im on the right method? They are both very different so there must be a reason you would go with one versus the other.
Click to expand...
TR is aggressive, more testing in both cycles, no dry food, reductions when below 50. Better chances of remission.

Start slow go slow is more..slow. Safer at some point. Reductions at 90, holding the dose longer. If one is gone most of one cycle and can't test as much, I'd go the safer way.

I'm at home, all day, every day so I can monitor closely. Catching up on sleep is hard... but hopefully it'll be worth it.
 
You must log in or register to reply here.
Back
Top