4/27 Lana AMPS 101, reduced dose, +1 171, +5 240, +9 473, PMPS 393, dose advice for next shot?

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Magali & Lana

Magali & Lana

Member Since 2018
Hello !

I already told that in my introduction :
Lana is 13 years old and weighs 5,6 kilos (12,3 lbs). She has been diagnosed as diabetic on March 30, 2018.
She received 2 UI of Lantus in the morning and evening during the first week.
Then, vet told me to inject 3 UI in the morning and evening because glycemia was at 495 mg/dl when he saw Lana after a week of treatment.
I started to follow glycemia at home on April 18.
With help of Stephanie and other members of facebook group, I inject now 2.5 UI.
I follow her consumption of water supplies and since the beginning of the month her water consumption has decreased

This is the spreadsheet of blood sugar levels :
https://docs.google.com/spreadsheets/d/1ZX5ePjfaGtyyEWP0NcO3xOqbNF0v5184P987jkzyGNQ/edit?usp=sharing.
Levels of blood sugar are sometimes low and I'm kinda lost.
How many Lantus should I inject tonight and next few days ?

Thank you in advance for your help and I'm sorry for my english ^^

Have a good day !

Magali



Bonjour!

J'ai déjà dit ça dans ma présentation :
Lana a 13 ans et pèse 5,6 kg. Elle a été diagnostiquée diabétique le 30 mars 2018.
Elle a reçu 2 unité de Lantus matin et soir pendant la première semaine.
Le vétérinaire m'a dit d'injecter 3 unité matin et soir par la suite car après une semaine de traitement, la glycémie avant injection était à 495 mg/dl.
J'ai commencé à suivre la glycémie à la maison le 18 avril.
Avec l'aide de Stephanie et d'autres membres du groupe facebook, j'injecte à présent 2,5 UI.
Je suis sa consommation d'eau et elle a diminuée depuis le début du mois.

Voici le tableau du suivi de glycémie :
https://docs.google.com/spreadsheets/d/1ZX5ePjfaGtyyEWP0NcO3xOqbNF0v5184P987jkzyGNQ/edit?usp=sharing
Les taux de glycémie sont parfois bas et je suis un peu perdue.
Combien d'unité devrais-je lui injecter ce soir et dans les jours à venir?

Merci d'avance pour votre aide et je suis désolée pour mon anglais ^^

Bonne journée!

Magali
 
As you told me that you won't be able to test much tomorrow (away at work) I would recommend a rather conservative dose.

Here's what we know by looking at Lana's spreadsheet:

- 3ui is too much (evening cycle of 25th)
- 1ui is not enough ;-)
- 2.5ui might be the right dose, but with 101 at AMPS, I'm guessing she went quite lower before that; the depot is kind of messed up by the dose changing so it is difficult to say
- as you won't be around to test, I would bet on 2ui for tonight and tomorrow morning; it might be a bit too low a dose but you want safety first if you're not around

Question to others: would you go lower than 2ui? I'm hesitating.
 
There have been a couple of different doses over the last few days.

It is hard to say that 1 ui is too low as it looks like a bounce is in play.

Maybe, stick to the 1 ui and keep that same dose for a week unless Lana drops and earns a reduction?
 
Hi and Welcome to Lantus & Levemir Land!

I agree with Tracey that your best option for the moment is to pick a dose and stick to it for, at minimum, six cycles (unless Lana tells you it's too much). Because Lantus is a depot insulin, you need to give each dose time to show its full effect. While I understand why you have been changing doses, doing so is counter-productive. It's hard to say if the low numbers Lana had Wednesday night were from the depot from the 3 unit dose or not, but it would have been better to take the reduction and hold the dose. Remember, dosing with Lantus is based mainly on how LOW the numbers go, with only a little consideration given to the pre-shot number. Try not to react to individual readings (unless they are very low), but to look at the cycle as a whole. My opinion is that you should keep the 1.5 unit dose for at least three days and then re-evaluate.

Have you had a chance to look at the two dosing methods we use here - Tight Regulation and Start Low Go Slow? Knowing which one you would like to follow will help us give you better suggestions. At the moment, if you are feeding any dry, you would need to follow the Start Low Go Slow method. Dry food, even the Hill's m/d, is high in carbohydrates and not really good for any cat, but especially for a diabetic. If you can switch her to all wet, that would be ideal. There are lower carb foods out there than the m/d wet, and they are generally less expensive. Stephanie will know what it available to you where you live, I think.

We're glad you joined us. Your English is very good. I have no French beyond Bonjour and oui, so I will use Google Translate:


Salut et bienvenue à Lantus & Levemir Land!
Je suis d'accord avec Tracey que votre meilleure option pour le moment est de choisir une dose et de s'y tenir pendant au moins six cycles (à moins que Lana ne vous dise que c'est trop). Parce que Lantus est une insuline de dépôt, vous devez donner à chaque dose le temps de montrer son plein effet. Bien que je comprenne pourquoi vous avez changé de dose, le faire est contre-productif. Il est difficile de dire si le faible nombre de Lana avait mercredi soir provenait du dépôt de la dose de 3 unités ou pas, mais il aurait été préférable de prendre la réduction et de maintenir la dose. Rappelez-vous, le dosage avec Lantus est basé principalement sur la FAIBLE quantité de chiffres, avec seulement une petite considération pour le nombre de pré-tir. Essayez de ne pas réagir aux lectures individuelles (à moins qu'elles ne soient très faibles), mais de regarder le cycle dans son ensemble. Mon opinion est que vous devriez garder la dose de 1,5 unité pendant au moins trois jours, puis réévaluer.
Avez-vous eu l'occasion d'examiner les deux méthodes de dosage que nous utilisons ici - Strict Régulation et Start Low Go Slow? Savoir lequel vous souhaitez suivre nous aidera à vous donner de meilleures suggestions. À l'heure actuelle, si vous nourrissez à sec, vous devrez suivre la méthode Start Low Go Slow. La nourriture sèche, même le m / d de la colline, est riche en hydrates de carbone et pas vraiment bon pour n'importe quel chat, mais particulièrement pour un diabétique. Si vous pouvez la mettre tout mouillé, ce serait idéal. Il y a des nourritures inférieures de carburateur là-bas que le m / d humide, et elles sont généralement moins chères. Stephanie saura ce que vous pouvez trouver là où vous vivez, je pense.
Nous sommes heureux que vous nous ayez rejoint. Ton anglais est très bon. Je n'ai pas de français au-delà de Bonjour et oui, donc je vais utiliser Google Translate:
 
Hi! Thank you for your advice.

You don't need to translate your message, I understand english easily. Speaking and writing is just a little more complicated for me :p

I was thinking about the dose before the injection of tonight and I decided to inject 1.5 and keep that dose for the week-end and maybe the beginning of next week because I don't wanna change the dose, it already had change too many times and it stressed me.

I was thinking about follow the TR. Lana eat m/d wet at the moment of injection and during the day I let m/d kibbles.

I forgot to tell you that I have two cats and I can't completely remove kibbles. And it would be too expensive for me to give only wet food for both cats.
 
Magali said:
You don't need to translate your message, I understand english easily. Speaking and writing is just a little more complicated for me
Click to expand...
How lovely! Compared to Europeans, we Americans are much less likely to speak/understand languages other than our own. I often wish I had tried harder to learn other languages when I was younger. You are doing very well.

I like your plan to hold the dose through the weekend and beyond. It looks like Lana may be bouncing right now. Great job getting all those tests - you will find that the spreadsheet is your best tool to help you see how she's reacting to the insulin.

Magali said:
I was thinking about follow the TR. Lana eat m/d wet at the moment of injection and during the day I let m/d kibbles.

I forgot to tell you that I have two cats and I can't completely remove kibbles. And it would be too expensive for me to give only wet food for both cats.
Click to expand...
I understand. Unfortunately, one of the pre-requisites of TR is that there should be no dry food in the diet. But SLGS is a bit more flexible, so you can follow that and test as much as you want/can, etc.
 
It's never too late to learn :P But thank you for your lovely words :oops:

I'm glad that you like my plan. Hope that we'll have good results.

So if I want to stay with the food that I actually use, I have to follow SLGS ?
Does it mean that I have to keep 1.5 unit for one complete week (except if Lana drops) for exemple ? And then, depends of results, I will increase or decrease doses ?
I admit it would be easier because today was a day off so I was able to test as much as I wanted but for exemple tomorrow I will be at work from 9 am to 6 pm. I can check on Lana during the lunch break but that's all I can do when I'm working.
 
Yes you would hold that 1.5u for 14 cycles (7 days) do a curve and then decide on the dosage based upon testing that was accomplished during the week.
Unless she drops below 90. If you catch a number below 90 then go down to 1.25u and hold that for a week.
 
Ok. I understand how it works.

Well I'm gonna think about the food because I keep TR on mind. I have to take some time to think about that.

And for the moment i'm gonna keep 1.5 ui and see what happens.

Thank you very much for your advices, it means a lot to me.
 
Hi Magali, Lana is adorable! :cat:

I agree, you need to find a dose and stick with it long enough that we can properly evaluate how low she is going and move from there.

SLGS can be modified to suit your cat, the guidelines are a starting point, but you can change the reduction point and just about anything else as time goes on so long as you know how your cat reacts on insulin. If you read the stickies at top, pay close attention to understanding onset, duration, overlap, nadir and carryover. So many things start to click once you get that down.

Regardless of the method you follow, I think you will soon see for yourself how frustrating it is to have kibble in the picture, it causes unpredictable glucose fluctuations and that can be extremely frustrating when attempting regulation. There are plenty of creative ways other people have figured out how to feed their cats different foods. Auto feeders are an option, eating in different rooms, some have even built special contraptions to keep one cat away from another cats food. Just some things to consider.
 
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