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[Sarah & Meki]

Hello

Our cat Meki has been on Lantus for a month now, after falling out of remission that lasted for 3 years. He eats low carb wet food only and we’re trying to follow TR. I’m unsure about the dosing and I would like to ask if anyone could check his numbers?

After he had a big fall at +3 on May 10th we were scared to shoot the same dose at PM so we lowered to 1.25 and kept it for two days and I’m afraid we messed it up because afterwards the 1.5 didn’t really take him low enough to keep the dose so we went higher, to 1.75, but this dose seems to be doing even less, also his ps numbers seem to be going higher. I’m very lost on what to do and also worried that we did something wrong and maybe missed the right dose.

Is it possible the dose is too high, and not too low? Sometimes his bg just keeps falling after his nadir, he also seems to be bouncing a lot(?) and the last time he was on Lantus he wasn’t this unpredictable so I’m wondering whether all of this is even normal.
Any advice would be much appreciated.

 

[Bron and Sheba (GA)]

Hi and welcome to the forum.
Looking at Meki’s numbers now.

 

[Bron and Sheba (GA)]

Hi Sarah and Meki.
Do you have a hypo kit set up incase you need it? If not I would recommend you get one set up asap. You never know when it might be needed.

If you are following TR or even SLGS you would not have reduced the dose when Meki dropped into the blue BGs (100s).
With TR you reduce the dose when he drops under 50 (2.8) or 90 (5) with SLGS.
It would have been better to stay with the same dose.
You are testing enough to see that he is not dropping too low and bouncing back up high.
I think you need to increase the dose of insulin up to 2 units.

If you could set up your signature that would help us learn about Meki and not keep asking you questions
HELP US HELP YOU https://felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

My Sheba fell out of remission after almost 3 years and I had a lot of trouble getting her back into decent numbers, and I couldn’t get her back into remission again. But in saying that, there are cats here that have gone back into remission so don’t lose heart.
I would recommend you start posting daily here so we can help you. Once we get you set up probably, we can send you over to the Lantus forum where everyone uses either Lantus or Levemir so you will get lots of daily help when you need it.

 

[Sarah & Meki]

Hi Sarah and Meki.
Do you have a hypo kit set up incase you need it? If not I would recommend you get one set up asap. You never know when it might be needed.

If you are following TR or even SLGS you would not have reduced the dose when Meki dropped into the blue BGs (100s).
With TR you reduce the dose when he drops under 50 (2.8) or 90 (5) with SLGS.
It would have been better to stay with the same dose.
You are testing enough to see that he is not dropping too low and bouncing back up high.
I think you need to increase the dose of insulin up to 2 units.

If you could set up your signature that would help us learn about Meki and not keep asking you questions
HELP US HELP YOU https://felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

My Sheba fell out of remission after almost 3 years and I had a lot of trouble getting her back into decent numbers, and I couldn’t get her back into remission again. But in saying that, there are cats here that have gone back into remission so don’t lose heart.
I would recommend you start posting daily here so we can help you. Once we get you set up probably, we can send you over to the Lantus forum where everyone uses either Lantus or Levemir so you will get lots of daily help when you need it.

Hi and thank you so much!

I have corn syrup, wet medium carb food and high carb food ready at all times.

I understand, I won’t reduce again unless he falls that low. So I just increase to 2 units tonight? or I wait until the next morning when I’m able to test more? I’m able to get a +3 every night but tonight I probably won’t be able to do much more than that.

Also what should I do the next time he falls a lot in the first 3 hours after the shot? When this happened we fed him medium carb at +3 already but maybe we should have waited...? But until when do we wait?

Okay I set up the signature, thanks for the link! I’m not entirely decided on the dosing method yet so I haven’t added it. We try to follow TR though.

I hoped we could get him back into remission but even regulation would be better than what we have right now. Everything was so much easier the first time he was on insulin.
Your Sheba looks beautiful in the photo by the way and I’m so sorry for your loss.

So, if I understand correctly, when posting daily I would just write a new post everyday with his preshot number and a few bg numbers after the shot and then others will tell me if they think he’s doing okay on that dose?

Thank you so much for your advice, I appreciate your help a lot!

 

[Bron and Sheba (GA)]

have corn syrup, wet medium carb food and high carb food ready at all times.

Great!

So I just increase to 2 units tonight? or I wait until the next morning when I’m able to test more? I’m able to get a +3 every night but tonight I probably won’t be able to do much more than that.

If it is not too long you can wait to increase when you can test although he may not do much in the first cycle. Whatever you feel comfortable with.

Also what should I do the next time he falls a lot in the first 3 hours after the shot? When this happened we fed him medium carb at +3 already but maybe we should have waited...? But until when do we wait?

You Can always get a +2 if you think he is falling. The onset of Lantus is around +2 so you can expect to get a drop at +3.
Do you give snacks during the cycles apart from the preshot meals? If you gave a small snack at +3 and +5 it may slow the drops.
I would only feed low carb to slow the drops unless the drop is very dramatic or the BG is low.

I’m not entirely decided on the dosing method yet so I haven’t added it. We try to follow TR though.

That’s ok. When you decide can you put it into the Ss and the signature please so we know as advice is different for each.

Everything was so much easier the first time he was on insulin.

I agree. I found the same thing.

So, if I understand correctly, when posting daily I would just write a new post everyday with his preshot number and a few bg numbers after the shot and then others will tell me if they think he’s doing okay on that dose?

while you are posting on the main health page, it is OK to keep using this thread until it gets to about 50 posts, then start a new one and link the last thread to the new one by copying and pasting the URL from the old thread.
After we get you set up properly and you feel comfortable, we will direct you over to the Lantus page where you do a daily thread the way you said above.

 

[Sarah & Meki]

Great!


If it is not too long you can wait to increase when you can test although he may not do much in the first cycle. Whatever you feel comfortable with.


You Can always get a +2 if you think he is falling. The onset of Lantus is around +2 so you can expect to get a drop at +3.
Do you give snacks during the cycles apart from the preshot meals? If you gave a small snack at +3 and +5 it may slow the drops.
I would only feed low carb to slow the drops unless the drop is very dramatic or the BG is low.


That’s ok. When you decide can you put it into the Ss and the signature please so we know as advice is different for each.



I agree. I found the same thing.


while you are posting on the main health page, it is OK to keep using this thread until it gets to about 50 posts, then start a new one and link the last thread to the new one by copying and pasting the URL from the old thread.
After we get you set up properly and you feel comfortable, we will direct you over to the Lantus page where you do a daily thread the way you said above.

So we ended up increasing to 2u the same night and his amps the next morning was 16.7 but afterwards he stopped dropping at all.
He reached blue numbers on the 1.5 dose, since then we’ve been raising his dose and he doesn’t even seem to drop anymore the higher the dose goes, is this normal? I don’t understand what’s happening anymore, if one dose brought him into blue numbers, shouldn’t higher doses just bring him lower not higher? It’s all so confusing

Oh okay I understand! I do feed small snacks so I’m just going to continue doing that.

Thank you so much for the tips!

 

[Bron and Sheba (GA)]

Have you decided if you want to follow TR or SLGS? You need to be feeding only wet food to do TR.
And test at least both preshots and once during all the cycles for TR. You are testing enough for TR.
He is possibly getting some lower BGs in the yellow range later in the cycles.
He probably has a bit of insulin resistance and the only way to break through that is to follow one of the dosing methods and increase the dose when appropriate.
You will get there….it’s just frustrating I know, having been there.

 

[Sarah & Meki]

I’m reluctant to decide for TR only because of fast dose increases, since I would like to try holding this dose for more days, so that probably means we’re following SLGS for now? He eats only wet food anyway, and we try to test even more to get more info on his numbers so I think we’re actually ready to follow TR but I do want to keep this dose for a while more. But in case this dose doesn’t end up working we will switch to TR.

Is it possible he’s got an infection and insulin just isn’t working properly? He’d been sneezing for a few months on and off and then after we’d moved to our new home his sneezing had stopped completely, but he fell out of remission.
We had his urine checked and it’s clear, but maybe he could have a uri... but in this case I’d imagine he never would have dropped no matter the dose, I’m not sure though...

 

[Bron and Sheba (GA)]

I’m reluctant to decide for TR only because of fast dose increases, since I would like to try holding this dose for more days, so that probably means we’re following SLGS for now? He eats only wet food anyway, and we try to test even more to get more info on his numbers so I think we’re actually ready to follow TR but I do want to keep this dose for a while more. But in case this dose doesn’t end up working we will switch to TR.

Is it possible he’s got an infection and insulin just isn’t working properly? He’d been sneezing for a few months on and off and then after we’d moved to our new home his sneezing had stopped completely, but he fell out of remission.
We had his urine checked and it’s clear, but maybe he could have a uri... but in this case I’d imagine he never would have dropped no matter the dose, I’m not sure though...

You can start with SLGS then do the swap to TR anytime you feel you want to as long as no dry food is being fed. With SLGS you can only increase each 7 days. However I would not hold the dose for too long if the BGs remain high.
It is possible for an infection to increase the BG. How are his teeth. They are often a reason why cats fall out of remission. Hiave you asked the vet about a URI?

 

[Sarah & Meki]

You can start with SLGS then do the swap to TR anytime you feel you want to as long as no dry food is being fed. With SLGS you can only increase each 7 days. However I would not hold the dose for too long if the BGs remain high.
It is possible for an infection to increase the BG. How are his teeth. They are often a reason why cats fall out of remission. Hiave you asked the vet about a URI?

Okay sounds great.

I think his teeth are okay, but I can’t be 100% sure because we haven’t been at the vet’s lately. After we moved I didn’t want to stress him out furtherly and right now I’m also looking for a new vet.

Some of his preshots have been lower than usual on 2u for the first time and we increased to 2.25 yesterday because it’s already been 7 days since the last increase and his nadir still wasn’t low enough. Today’s amps was 223, and since it was his lowest preshot number, we decided to not give a full dose of 2.25 but a skinny one. The lowest he dropped today was @6.25 when he dropped to 79 and also today was his first time testing in green numbers. He got snacks in between tests and a low carb meal @3 and @6.25. I’m happy we managed not to panic and only fed him low carb.

So according to SLGS we’d have to reduce now that he’s dropped under 90, but it’s only been a day on this dose, is it even okay to just reduce so fast, I’m afraid he would just go back into high bg numbers? If we did TR he’d have to drop even lower to be able to get a reduction. He’s been feeling so much better in lower numbers, I’d hate to mess this up somehow so now I’m wondering if we should push him lower. The problem with that is that his blood glucose number while in remission was always between 4.4 and 4.7, but when he dropped lower while on insulin he wasn’t being himself, he was more lethargic and I’m afraid this means those lower numbers won’t feel right for him and could push him into hypo.

I’m not sure what to shoot at PM. Should I reduce by 0.25, so we go back to 2u? Or just shave off the dose, so we’d go from 2.25 to 2.1u?

 

[Bron and Sheba (GA)]

If you are following SLGS you need to reduce the dose back to 2 units. Have you decided to follow SLGS? When you decide pop it into the signature and SS please.
If you decide TR you stay with 2.25 U