4/28/2020 Leo 79 AMPS

J

Jessica Hamberger

Member Since 2020
https://docs.google.com/spreadsheet...0gjFGBa6hBdTXfK8qHdNQQlQGo/edit#gid=361360320

Hi Leo was on 1 unit Lantus am and .5 pm. Diagnosed 3/16/2020. Blood test from 3/14/2020 bg was at 543 and Only 7 weeks had passed between then and last blood test in which his bg was normal. He was on 5mg prednisolone a day and he is down to 1.25 mg every 3 days. He has controlled IBD, severe asthma, early stage CKD, pancreatitis. He is diet is cooked elk/venison with bison liver and alnutrin supplement. One of the things I noticed on his last blood test was that his pancrea...s numbers was at a 45 which is very high and his triglycerides and cholesterol was through the roof. I think it was caused from the pork loin and duck fat (for constipation) caused all 3 of them to go very high which was all stopped on 3/16/2020. I am wondering if the steroids and high fat content stressed his pancreas even more which caused the diabetes. We are doing another blood test in two weeks to see if his numbers have changed. I spoke with my vet last night and she said his numbers are getting too low and thinks he holds on to the insulin longer so wants me to do only one unit in the morning. I feel like I should do .5 in am and .5 in pm because the lantus is supposed to be given every 12 hours. I only gave .25 this morning because he was 79. I am hoping remission will be possible.
 
Because Lantus is a depot insulin (read more about that here: http://www.felinediabetes.com/FDMB/threads/what-is-the-insulin-depot.150/), dosage changes can affect the BG for up to 3 days (or 6 twelve hour cycles) later. This means that, in general, if you change his dose for some reason, you usually try to hold that dose for at least 3 days, unless he hits one of the dosage thresholds as outlined in the dosing method you are following (FDMB dosing methods for Lantus are found here: http://www.felinediabetes.com/FDMB/...-low-go-slow-slgs-tight-regulation-tr.210110/). And dosage changes are recommended to be only .25 units at a time.

I am not very experienced because Boris was only on insulin for a few months, so I don't want to make a dosing recommendation. There's a lot of blue and green on your spreadsheet right now, which is good news for Leo! Hopefully that means he'll need little to no insulin moving forward, but those with more experience can probably give you better advice.

Hopefully some others will chime in shortly to give additional feedback.
 
Welcome to the forum, here is a link on how you can help us help you...http://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

Great job doing home testing, and getting your spreadsheet going, can you tell us what meter are you using, i.e. pet or human? Yes, Lantus does like consistency, so changing up doses a.m. and p.m. doesn't tend to work. You could keep with 0.25u and see how things go. That said, is Leo still being weened off the pred? The steroids can contribute to diabetes occurring in the first place, but now that you are tapering him off, I'd watch the blood glucose a bit more closely.
 
Christie & Maverick said:
Welcome to the forum, here is a link on how you can help us help you...http://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

Great job doing home testing, and getting your spreadsheet going, can you tell us what meter are you using, i.e. pet or human? Yes, Lantus does like consistency, so changing up doses a.m. and p.m. doesn't tend to work. You could keep with 0.25u and see how things go. That said, is Leo still being weened off the pred? The steroids can contribute to diabetes occurring in the first place, but now that you are tapering him off, I'd watch the blood glucose a bit more closely.
Click to expand...
Hi, he is on the Free style Libre human. I just updated my signature post his spread. Yes he is on 1.25 now every 3 days for the next week then every four days and then hopefully done,
 
Christie & Maverick said:
Welcome to the forum, here is a link on how you can help us help you...http://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

Great job doing home testing, and getting your spreadsheet going, can you tell us what meter are you using, i.e. pet or human? Yes, Lantus does like consistency, so changing up doses a.m. and p.m. doesn't tend to work. You could keep with 0.25u and see how things go. That said, is Leo still being weened off the pred? The steroids can contribute to diabetes occurring in the first place, but now that you are tapering him off, I'd watch the blood glucose a bit more closely.
Click to expand...
Hi do you mind looking at Leo’s spreadsheet..I just gave him his 4th dose of .25 and he is still low. I think I am going to check his bg in the middle of the night to make sure he is not going too low.
 
Hi Jessica, the am cycles are looking good, I agree, it would be nice to see a test or two before bed, to gain some visibility on what he might be doing at night. I'd suggest getting a +2 to start, since we often find that the +2 is a good indicator of how the cycle may go on Lantus. If the +2 is higher than your preshot, Leo most likely won't have too much in store for the rest of the night, he'll likely come down, but not very drastically. Whenever I used to see a higher +2, it meant I didn't really need to test anymore. If the +2 is about the same, I often got another test just to make sure the cycle wasn't too crazy. What you want to catch is A lower +2, because those often mean you need to watch a little more closely, and possibly intervene with higher carb foods if necessary to slow the drop. To clarify, when I say +2, that means 2 hours after insulin shot.

Leo doesn't seem super bouncy, which is a good thing. He is tending to stay fairly flat for the most part. How do you feel about getting a +2, post the number and we'll go from there?

Also, I know there is a lot of info that I have sent your way, but I'd like to point you to the sticky about dosing methods here:
http://www.felinediabetes.com/FDMB/...-low-go-slow-slgs-tight-regulation-tr.210110/

You may not need it for long, but deciding on the dosing method helps, because it affects what advice people will give you about dosing, increases, and reductions. As long as you aren't feeding any dry food, you can select either. If there is dry in the mix, you must follow SLGS.

Questions? :)
 
Christie & Maverick said:
Hi Jessica, the am cycles are looking good, I agree, it would be nice to see a test or two before bed, to gain some visibility on what he might be doing at night. I'd suggest getting a +2 to start, since we often find that the +2 is a good indicator of how the cycle may go on Lantus. If the +2 is higher than your preshot, Leo most likely won't have too much in store for the rest of the night, he'll likely come down, but not very drastically. Whenever I used to see a higher +2, it meant I didn't really need to test anymore. If the +2 is about the same, I often got another test just to make sure the cycle wasn't too crazy. What you want to catch is A lower +2, because those often mean you need to watch a little more closely, and possibly intervene with higher carb foods if necessary to slow the drop. To clarify, when I say +2, that means 2 hours after insulin shot.

Leo doesn't seem super bouncy, which is a good thing. He is tending to stay fairly flat for the most part. How do you feel about getting a +2, post the number and we'll go from there?

Also, I know there is a lot of info that I have sent your way, but I'd like to point you to the sticky about dosing methods here:
http://www.felinediabetes.com/FDMB/...-low-go-slow-slgs-tight-regulation-tr.210110/

You may not need it for long, but deciding on the dosing method helps, because it affects what advice people will give you about dosing, increases, and reductions. As long as you aren't feeding any dry food, you can select either. If there is dry in the mix, you must follow SLGS.

Questions? :)
Click to expand...
I will definitely test in an hour which will be the two hours post shot. I think I am going to set my alarm to do another one also. Silly question but how would I ever try to go below.25 per dose that in itself is hard to be accurate. How would I know by his levels to reduce to .25 a day? Does he have to be in green for several weeks? And he has only two doses of pred and he will be done. He eats homemade food so no carbs but I do have honey if needed. Thank you for your help!!
 
With TR, you reduce if you get a BG test under 50. With SLGS you would reduce under 90. Or reduce after a week if Leo spends most time in greens. The next step down would be 0.1u ...you're right, tricky to eyeball, it's less than 0.25u but more than the zero line. How good are your eyes? :p

Here's a pic from one of the stickies that shows fine dosing...

http://www.felinediabetes.com/FDMB/...info-proper-handling-drawing-fine-dosing.151/

You can also experiment a bit ... draw up 0.5u and slowly squeeze out the drops while counting, and see how many drops you have before you get to 0.25u and then to zero. If your squeeze technique gives you 4 drops from 0.5u to zero, then I'd say your 0.1u would be what's left after you squeeze out 3 drops. Make sense?
 
Christie & Maverick said:
With TR, you reduce if you get a BG test under 50. With SLGS you would reduce under 90. Or reduce after a week if Leo spends most time in greens. The next step down would be 0.1u ...you're right, tricky to eyeball, it's less than 0.25u but more than the zero line. How good are your eyes? :p

Here's a pic from one of the stickies that shows fine dosing...

http://www.felinediabetes.com/FDMB/...info-proper-handling-drawing-fine-dosing.151/

You can also experiment a bit ... draw up 0.5u and slowly squeeze out the drops while counting, and see how many drops you have before you get to 0.25u and then to zero. If your squeeze technique gives you 4 drops from 0.5u to zero, then I'd say your 0.1u would be what's left after you squeeze out 3 drops. Make sense?
Click to expand...
His bg +2 is 93. I will set my alarm for +6 to see. Thanks for the link to the pics. I have a magnifying glass which I think will help me get accurate doses.
 
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