6/14 Casper - Need advice for PMPS

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wayleng

wayleng

Member Since 2010
I am new to the boards but working on Casper's diabetes since late February. She was doing really well until about 3 weeks ago, when her numbers started escalating. We went to the vet last Monday for a check and blood/urine results came back fine. But the vet increased her dosage to 3-4 units 2x/day. Over the weekend, I cut both of our cats off of dry good (Purina DM) and switched them over to FF. I was seeing positive results in Casper's readings until this morning where it shot up to 479 (first test) and then 465 (second test). Fortunately, I was able to work from home today so that I could do a more formal testing of her levels throughout the day.

AMPS (7:00am): 478/465 shot 3u followed by breakfast
+2: 329
+4: 244
+6: 195
+6.5: Snack
+8: 204

The general consensus seems to be that the revised dosage from the vet last week is too high and that I should start over with 1u. As you will see in our SS, we did very well on 1u and that was when she was eating Purina DM dry (no wet food). Today looks like a good day and maybe that we are on our way back to where we were. So my questions are: can I just drop it all the way back down to 1u? Or do I need to step it down? Or go 1 more day at the 3? Thanks for any advice you've got.
 
There are a couple of things we do differently than what your vet is advising. First, we shoot the same dose at AM and PM shot times. We also increase in small amounts -- 0.25u -- not in increments of 1.0u. (You may want to get syringes that are marked in 1/5u doses.) It's very easy to miss an optimal dose when increasing in large amounts. We also strongly push Lantus users to get mid-cycle spot checks. Lantus dosing is based on the lowest point of the cycle (the nadir) and not on pre-shot blood glucose levels. Please take a look at the LANTUS & LEVEMIR - TIGHT REGULATION PROTOCOLS sticky. It contains links to the formal versions of the Lantus dosing protocols as well as a modified version that we use here.

When members here have started over with dosing, they often do drop the dose back vs. tapering it back. Frankly, given that you switched from dry to canned LC food, dropping the dose may be a wise choice. My reason for saying this is that is in the absence of any spot checks, my guess is that Casper hit some low numbers last night and his AMPS reflects a bounce. No matter what you decide to do, please consider getting spot checks on a routine basis.
 
Looks like from your ss that Casper was doing well on 1.00--Yesterday, although started out high, she came down to blue, which was good ..
Please put dosing advice in your subject line to alert our dosing helpers that you need some more guidance..OK?
Welcome to Lantus Land :-D
 
welcome to Lantus Land!

that is a pretty big jump, to go from 1 unit to 3-4 in one fell swoop.

Do you have high carb wet food on hand (something like the Fancy Feast varieties with gravy, which are mostly around 18% carb). Are you able to keep testing for several hours into the evening cycle tonight so we can see what is going on? If you're well equipped with high carb food (wet is better than dry), then i wouldn't mind seeing one more cycle at 3 units, just for data gathering purposes.
 
I can probably get 3 more readings tonight - 7:00, 9:00 and 11:00. I don't have any high carb wet yet, but I can run to the store to get a couple of cans to make sure I have it on hand.
 
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