6/30 Miss Kitty AMPS 318 New and need dosing advice

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april925

Member Since 2011
Hi

I have been posting on the FDMB. I've finally been able to create a spreadsheet. My cat, Miss Kitty, has been close to remission, she was off insulin for about a week, but then we had a vacation scheduled for 5 days, I ended up telling the pet sitter not to give her the insulin because her numbers were staying in normal range prior to leaving, but now she is back up a bit. She has been close before, but she ends up going back up. She is now eating Merrick's Cowboy Cookout wet food, was on Hill's W/D wet. She has been taking insulin since December. She is still a bit overweight too. Has lost some weight, went from 15 pounds to 12. Vet says she should be at 9. I forgot to say how much insulin, which right now, is 1 unit. She has never been higher than 2 units. When she has been on 2 units, after a bit, she goes low. So, it seems 2 units are usually too much and sometimes 1 is not enough.

Thanks

https://spreadsheets.google.com/spreads ... utput=html
 
Re: Newbie Dosing Advice

Welcome to LL! I'm sure someone will come along soon to give you some advice. However, we wanted to say hello!
 
Re: Newbie Dosing Advice

Hi Alice and Miss Kitty and welcome,

I hope that one of our very knowledgeable people will be along today to help you. I just looked at your spreadsheet and it is beyond my "skills" to try to interpret it correctly. While you are waiting, I would suggest that you read the informational "Stickies" at the top of the Lantus Forum, especially the "New to the Group". This will start you off on how we proceed and will tell you something about the Tight Regulation Protocol we use. Am I correct in assuming that Miss Kitty was on a different insulin when you started treating her diabetes in December? Our dosing experts will want to know that (and what dose she was on then), and also other things, such as how old she is, if she has other health issues, when you switched her food to Cowboy Cookout, etc. There are instructions for creating a "Profile" so that the people here will be able in the future to see at a glance all your particulars. See the following for the instructions:
http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=17766

Your doses have been inconsistent (or skipped), so it is difficult to see any patterns from your spreadsheet. You will probably be advised to begin again at an appropriate dose (please wait for one of the dosing experts to help you determine what an appropriate dose for Miss Kitty would be. There is a formula based on ideal weight, but I can't put my finger on it at the moment.) Most people here start their cats with 1 unit, twice a day (every 12 hours) and then stick with that dose for about a week so that the "shed" or "depot" has a chance to build (this is a "reserve" of Lantus that builds under the skin and is very important for achieving good regulation). We then begin to raise the dose slowly and in small increments-- according to the protocol-- until an ideal dose is found. However, if it becomes immediately apparent that the 1-unit dose is too much, the knowledgeable people will advise you to lower it.

There is lots of fun reading in the "Stickies"!! You are in a good place to get help and support. We all want the best for you and Miss Kitty. Please be patient and some experienced help will be along soon.

Again, Welcome to Lantus Land!

Ella & Rusty
 
Re: Newbie Dosing Advice

Thanks

Miss Kitty has been on Lantus since starting out in December, she started out at 1 unit twice a day. She has been raised to 2 units, but that usually ends up being too much, so the vet tells me to go back to 1 or not give her any. She ate dry food all her life up until the diagnosis and of course the vet put her on Hill's W/D wet food. From reading here, I saw that the W/D is still high in carbs, so I just switched to the Cowboy cookout on about 6/21/11. She is 14 years old.
 
Re: Newbie Dosing Advice

Hi again, April,

When we raise the dose according to the protocol, it is only by 0.25 of a unit. The new dose is then held for at least six 12-hour cycles (3 days) so that it's effect can be observed and the shed can adjust to the new dose. If your vet raised the dose by 1 whole unit, it may indeed have been too much and caused Miss Kitty to bypass her ideal dose at that time. It is odd that your vet would tell you that if the raise to 2 units was too much, you should go back to 1 unit or not give any insulin at all (my italics). That's why the protocol we follow here is safe: it allows the cat to find the correct dose without having to cope with potential overdose.

Keep reading, and, when you have a minute, please go back to your first post of the day and edit the subject box. Your entry will look like this: "6/29 Miss Kitty AMPS 338. New and need dosing advice" This should get more eyes on your "condo" (we call each day's thread a "condo"). Anytime you want to add new bg numbers during the course of the day, or need more help, go back to this first post of the day and edit the subject line there (this keeps your subject line up to date; if you change it in a later post, it will only register in that post, not in the day's "condo" as a whole).

Good luck. Some knowledgeable people who can give you dosing advice will surely be along later, after they get home from work.

Ella & Rusty
 
Re: 6/29 Miss Kitty AMPS 338 PMPS 185 New and need dosing ad

Thanks Ella

I just did her check prior to the evening dose and she is at 185, so now I don't know whether to give any or not. Right now is the time for her shot. Not sure if I should give another whole unit.
 
Re: 6/29 Miss Kitty AMPS 338 PMPS 185 New and need dosing ad

I gave her slightly less than one unit.
 
Re: 6/29 Miss Kitty AMPS 338 PMPS 185 New and need dosing ad

Hi April, welcome, and you've come to a great place for help. Ella has given you some good information on reading the stickies. Others should be along shortly, too for more advice. Looking forward to getting to know you and Miss Kitty.
 
Re: 6/29 Miss Kitty AMPS 338 PMPS 185 New and need dosing ad

Hi April: welcome!!! We will definitely need one of the more experienced dosing folks to have their eyes on your SS.

Since you don't have much data and you don't know if you shot a dropping number, could you please get a +1 and +2 test so we can make sure Miss Kitty is not dropping rapidly?

The formula for determining starting insulin is:
.25u per kg

If Miss Kitty weighs 13 lbs that is 5.9 kg x .25u = approx 1.5u bid. That is just an estimation but I thought I'd provide it since Ella mentioned it. Miss Kitty may need less. I would not change her dose based on that...again...it's only information. I would wait until one of the experienced dosing folks can offer you suggestions on dose.
 
Re: 6/29 Miss Kitty AMPS 338 PMPS 185 New and need dosing ad

Thanks Marjorie

I planned on checking her at least one more time tonight, but I can definitely do it at +1 and +2 hours.
 
Re: 6/29 Miss Kitty AMPS 338 PMPS 185 New and need dosing ad

You're welcome. If she's dropping at +2, you will need to get more tests :-D
 
Re: 6/29 Miss Kitty AMPS 338 PMPS 185 New and need dosing ad

When I have curved her in the past, her lowest reading usually comes about 4 to 4 and a half hours after her shot.
 
Re: 6/29 Miss Kitty AMPS 338 PMPS 185 New and need dosing ad

Welcome Alice!

My guess is that there are a couple of dosing issues that are going on. If you are changing your dose in whole units, that may be accounting for the highs and lows. As others have mentioned, we use a dosing protocol that has solid, published research behind it. Based on that protocol, dose changes are typically made in 0.25u increments. If you do not already have them, you will need to get syringes that are marked in half unit increments. (By any chance are you shooting directly from a Lantus pen?)

The skipped shots also make it hard to evaluate dose. Because Lantus is a long acting, depot-type of medication, any time you skip or reduce the dose, it effects the depot. (We refer to the depot as the "shed.") This can cause blood glucose numbers to get a bit wonky.

I'm glad you shot tonight. For now, the goal will be to shoot the same amount consistently unless Miss Kitty's numbers drop to less than 50 -- then she earns a dose reduction. It's very important that you review the starred, sticky notes. It's also important that you have extra strips and high carb food on hand. This will allow you to steer lower numbers effectively should the need arise.
 
Re: 6/29 Miss Kitty AMPS 338 PMPS 185 New and need dosing ad

Hi April,

wow, Miss Kitty is doing great! Based on what I'm seeing on your spreadsheet, I would be inclined to lower her dose a little bit to see if that leaves you with a number you can shoot reliably every 12 hours. It looks like whenever you give 1 unit, you usually end up skipping the next shot. Can you measure 0.75 units? That might bump her up just enough so you can shoot twice a day, and that should help flatten her numbers out.

In the meantime, I agree with Marje that you should plan to get a couple of tests tonight. +2 for sure and we'll see where she is going from there. It will be good to see if she is still dropping and how low she is going at night.

Welcome to Lantus Land!
 
Re: 6/29 Miss Kitty AMPS 338 PMPS 185 New and need dosing ad

Thanks Libby

Are there needles out there that measure increments like that? I have these needles that are thinner and so the 1 unit marks are wider so that you can aim in between them better, but needles with the small increments would be great. That's sort of what I just tried to do with her evening dose, I tried to put the plunger up over the line, but it may not have been as low as 0.75. It's time to do the +1 hour check....
 
Re: 6/29 Miss Kitty AMPS 338 PMPS 185 New and need dosing ad

there are some manufacturers that make syringes with 0.5 unit markings. None that make markings any smaller than that, though. Wal-Mart's ReliOn syringes come with 0.5 unit markings, if you get the 3/10cc syringes.
 
Re: 6/29 Miss Kitty AMPS 338 PMPS 185 New and need dosing ad

Can you just go in the Walmart and buy them without a prescription? Just did her check and she is at 200 at +1 hour.
 
Re: 6/29 Miss Kitty AMPS 338 PMPS 185 New and need dosing ad

check at +2 hours is 222. Odd that it has gone up a bit.
 
Re: 6/29 Miss Kitty AMPS 338 PMPS 185 New and need dosing ad

Whether you need a prescription for syringes depends on what state you live in. However, if you order syringes on-line, you don't need a prescription. These are the syringes I use.
 
Re: 6/29 Miss Kitty AMPS 338 PMPS 185 New and need dosing ad

Totally off topic but weight loss in cats needs to be done slowly so they don't get feline hepatic lipidosis. Use an accurate scale and make sure to keep it at no more than 1-2% of weight loss per week. And make sure you give a few weeks of maintenance to give the liver a break. Maverick's vet told me he had to lose weight but never told me about FHL and he almost died from it.

You are in amazing hands here!!! Welcome to Lantus Land.
 
Her amps check is at 318. Not sure why she is not coming back down. Please advise, I will give her 1 unit this morning, maybe I should give more, not sure.

By the way also, when it's a new day, do you start a new post or do you edit the subject of the original one? I edited this time.

thanks
 
Hi -

I don't remember if I've visited your condo before or not. When it's a new day, you start a new condo - it's a one condo per day sort of thing.

I can't access your spreadsheet, plus I'm pretty new to this stuff too (5 months in now), so I'll leave your dosing question to someone more experienced. However, I can say that Lantus does like consistency, and unless Miss Kitty earns a reduction by dropping below 50, you do want to hold a dose for at least 6-10 cycles (3-5 days) before making any adjustments.

I'm sure someone else with more experience will come along shortly with more specifics! Have a great day.

Amy
 
Good Morning & Welcome :-D

That 318 certainly looks shootable to me, Miss Kitty was at 338 yesterday, BUT I'm new too so maybe wait for more
experienced eyes (should be here soon).

We start a new thread every day, with a link to the previous day's thread... that way any one giving you advice can
refer back easily without searching etc.
 
Good morning. Welcome to you and Miss Kitty. :smile:
You can start a new thread which we call condo's here. You put the date in the subject line with the kitty's name and AMPS...like you already did.

It does look like a shootable number. Are you home during the day to monitor?

One question....what are the syringes you are using...just curious?
 
I meant to add that Libby suggested you shoot 0.75u instead of 1.0u. It may be hard to measure without syringes with 1/2 unit markings but maybe you can measure a little less than the 1.0u line.
 
Oh boy, I gave her the full unit this morning. I am not home to check her throughout the day, but I will check when I get home before her evening shot. My husband is here, but he cannot check her BG, he can keep an eye on her and he knows about the Karo syrup in the pantry if need be.

How to you link your previous day's post to the new one?

Someone earlier mentioned the Relion needles at Walmart, do you know if you can go get them without a prescription?
 
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