8/17 Cheshire AMPS:126, 1:314, 2:351, 3:311 6:261, 9:240

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Chris & Cheshire

Chris & Cheshire

Member Since 2013
Hi Guys, newbie to the TR boards. First day with Lantus, been on 1U Humulin N for a month.

Actually, I'd like to confirm my decision this morning (before actually doing it). My plan was to start Lantus this morning so I can watch the first cycle closely all day. However, Cheshire decided to test at 126 this morning, which is pretty low for him. Typically, that would mean no-shot on the Humulin.

My reading of the Lantus protocol is that dosage reductions are based more on the nadir than the PS test, so I should give the initial 0.5U Lantus this morning, then test at +1, +3, +6, +9...

Does that sound right? Just don't want to shoot when I shouldn't at get myself into a hypo situation on day 1.
 
Re: 8/17 Cheshire AMPS 126

Welcome to Lantus Land!

On this Board, we typically use 150 as a "post an ask for help" number until you have data to shoot low. Since you're not entirely new to feline diabetes, it's your call if you want to shoot or if you feel more comfortable "stalling." If you stall, you don't want to feed Cheshire. Instead, wait 15 - 30 min. and re-test to see if numbers are rising.

I'm going to add another post but I wanted to respond quickly to your question.
 
Re: 8/17 Cheshire AMPS 126

Morning Chris -

Welcome to TR Board. Just wanted to say HI

I am not able to give dose advise - someone with more experience will be along to help.
Good luck with the switch to Lantus

** You might want to update your existing/first post with a "Question Mark" icon and put Dose Question in the Subject Text.
 
Re: 8/17 Cheshire AMPS 126 (1st day on Lantus - dose or no d

Thank you both, Sienne and Rich.

It's too late on no-food, breakfast has come and gone. We're about 45 minutes after now, and BG is 165.

I've edited the post title/icon - thanks for that pointer. Will be a good thing to remember in the weeks and months to come. :)
 
Re: 8/17 Cheshire AMPS 126

There are several differences between Lantus and Humulin N (also referred to as N). You're correct -- dosing with Lantus is based on nadir. Pre-shot numbers are important from the standpoint of knowing if it's safe to shoot but you base your dose adjustments on the nadir. The Tight Regulation Protocol sticky outlines the details of increasing and decreasing Cheshire's dose.

It looks like you attached a copy of the Start Low Go Slow approach to your spreadsheet (SS). You are welcome to use that approach here. One note, though, is that with Lantus, the dose changes are in the amount of 0.25u, not 0.5u as noted in SLGS.

Another difference with Lantus is that many of us shoot while our cat is eating. Lantus takes approximately 2 hrs for onset (although this can vary depending on the cat) so you have a bit more flexibility than you do with N where you cat needs to have food on board prior to shooting.

Doing a mini-curve they way you specified today may be helpful. It takes roughly 5 - 7 days for the Lantus depot to be established. Lantus is a long-acting, depot-type of insulin which is a fundamental difference between Lantus and N.
 
Re: 8/17 Cheshire AMPS 126 (1st day on Lantus - dose or no d

Did you shoot?

If you did, that's fine. I would, however, get a +1 and +2 test. Getting early tests is pretty much a standard practice here if you are new to shooting lower numbers.

For reference, you might also want to take a look at this sticky on Shooting & Handling Low Numbers. (We pretty much have sticky notes and reference posts on pretty much anything.
 
Re: 8/17 Cheshire AMPS 126 (1st day on Lantus - dose or no d

Yep, we shot a couple minutes ago. It begins! Roger that on getting +1 and +2.

So, dorky, detailed question: How do I handle this morning on the spreadsheet? My first AMPS was 126, but the reading that ended up actually being pre-shot was the second test, 165. I put the 126 in the notes, and list 165 as the AMPS. Is that what you guys would do?

The stickies on this board are great. It may not be the coolest thing I've ever done on a Friday , but I had a hot date reading through the stickies last night. :)
 
Re: 8/17 Cheshire AMPS 126 (1st day on Lantus - dose or no d

Hey there welcome to Lantus land! I posted in your last condo on health http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=99834

I would put the 126 in yesterdays +11 column and the 165 as AMPS.

two little things :
Can you do line on your SS above today that says in big bold and a different colour "moved to lantus"?

You might want to change the BG<40 to also green because that threw me off. I understand why you did it and I think its a good idea but its not what the majority are used to. Maybe make it a different shade of green instead of orange? like a different shade with bold letters?

Wendy
 
Re: 8/17 Cheshire AMPS 126 (1st day on Lantus - dose or no d

Thanks, Wendy - made both the spreadsheet modifications.

We're at 314 for +1, standing by for +2. He's going to get so much parmesan cheese today, he's going to be spoiled. Definitely getting pumpkin with tonight's meal, too. :)
 
How did things go this weekend with Ches? It looks like he's coming down across the board with no readings over 300 since just after you started the Lantus.
 
Hey Kay - Thanks for checking in. :) I have no idea how your head doesn't spin 'round with all the new people who pour through here.

It's been all good news around here; the Lantus pretty immediately evened Ches's BG readings out, which makes me very happy. I have to travel for the next week and will be boarding the cats, so we won't be increasing the dose for a couple weeks, but the early signs make me think we'll inch up to .75U next time we have a weekend.

The good news is that the vet I'm boarding with is a lot more diabetic-informed - they prescribe ProZinc but were familiar with Lantus, and the staff was pretty nonchalant about multiple BG tests a day. Later tonight I'll be typing up my instructions for them, and pulling together all the medical records, etc. :)

What about you? How are things with Michelangelo? I'm trying to read the spreadsheet, but I don't think I know enough about normal patterns yet. It looks like he's a little erratic lately, but overall his number are coming down quite a bit.
 
Chris & Cheshire said:
Hey Kay - Thanks for checking in. :) I have no idea how your head doesn't spin 'round with all the new people who pour through here.
Click to expand...

I have an eidetic memory, so I'm sort of cheating. ;-) :lol:

Make sure they know not to dose him on a sliding scale and to hold the dose consistent regardless of what his pre-shot numbers are (as long as they're over your no-shoot number). That's the biggest difference between ProZinc and Lantus. When I'm gone, I also have them give a slightly decreased dose because Mikey has a tendency to run low when I'm not there, so holding off on the dose increase till you get back sounds like a good idea.

Yeah. I don't know what's up with Mikey. Maybe he's headed towards remission? nailbite_smile I feel like I'm jinxing things just saying that out loud. :lol: I've just decreased him again to 1.25u tonight because he's been running a little low well past pre-shot. Ever since the middle of June he's thrown me for a loop. Part of it might be because he's slowed down on his growing (no longer gaining a pound a month), part of it might be seasonal fluctuations, and part of it might be just because he's got a contrary disposition. :roll:
 
Well, he's heading in the right direction, so that's a good thing.

Your sig says he was diagnosed just a few months after being born, right? So for him it's genetics, not diet, right? Does that change things at all?
 
He's basically an unknown. There aren't many cats like him (they rarely survive long enough to get diagnosed) and the few that are, their owners don't home test (they were literally left at the vet's for the first few months). He's pretty much setting a precedence. Cats who get diabetes later in life can achieve remission; but a cat born with diabetes...who knows! Maybe born feline diabetics can also achieve remission, just none of them have succeed so far.
 
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