Hi Christine! it's just before midnight here on the west coast of the US!
Here's the part of the protocol that you want:
http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581
"General" Guidelines:
Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).
Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).
Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.
Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Reducing the dose:
If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.
If an attempted reduction fails, go right back up to the last good dose.
Try to go from 0.25u to 0.1u before stopping insulin completely.
the critical numbers for deciding on dose changes are the mid-cycle numbers. the lowest point of each cycle is the nadir. someone with more experience than me can advise you, but generally speaking you look at the lowest point numbers to make dose decisions. Ahmin had a 108 last night, and probably something less than 100 in the morning, since he was at 103 at +3, and a 94 a couple of days before that.
His nadirs are definitely less than 200 (I bolded the part above that fits Ahmin's situation) - really pretty good numbers. You probably only need a tiny increase to push his numbers down overall. When you increase his dose you want to make sure and catch the mid-cycle numbers, both morning and evening if you can. Your goal is to keep him from going under 40.
When he gets down to 50 or below, you apply the directions from the "How to treat low numbers" sticky at the top of the Lantus forum.
I test preshot, +2 or +3 (because it tells me if punkin's going to go significantly down) and +5 or +6 (because that's usually punkin's lowest point) and sometimes again at +9. It's helpful to vary the test times a little so you see what Ahmin's patterns are. It's a good idea to get checks the first half of the cycle so Ahmin doesn't slip too low without you being aware of it.
it's also a good idea to make sure and always have high carb canned cat food, karo syrup and plenty (50) of test strips and lancets on hand so you don't get caught without supplies if you need them.
