9/14 Millie AMPS:448 +2:302 +5:157 +6:419 +9:HIGH
- Thread starter Miggins
- Start date
Summer and Susie (GA)
Member Since 2020
Nice blue today. Hope the increase helps to get rid of those blacks.
Miggins
Member Since 2021
Thanks! I had really hoped she would have spent a little more time in the blue before she decided to bounce…clearly not given the +6 reading
Bandit's Mom
Member Since 2019
Hi Karen!
Welcome to the LBL forum! Glad you were able to finally make the switch to Lantus.
Link to your first post in the Main Forum: https://www.felinediabetes.com/FDMB/threads/introduction-from-long-time-lurker.251964/
Btw, what syringes are you using? 8.5mm on the callipers for 1U??!! It's usually anywhere between 1mm and 1.6mm per unit.
The Lantus depot take a week to build. Is your vet guiding you wrt dosing? These are the dosing protocols we follow here:
Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)
Since you're feeding LC wet and can get enough tests an aggressive protocol like TR may be better for Millie. Especially with a history of DKA.
Good luck with Lantus.
Welcome to the LBL forum! Glad you were able to finally make the switch to Lantus.
Link to your first post in the Main Forum: https://www.felinediabetes.com/FDMB/threads/introduction-from-long-time-lurker.251964/
Btw, what syringes are you using? 8.5mm on the callipers for 1U??!! It's usually anywhere between 1mm and 1.6mm per unit.
The Lantus depot take a week to build. Is your vet guiding you wrt dosing? These are the dosing protocols we follow here:
Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)
Since you're feeding LC wet and can get enough tests an aggressive protocol like TR may be better for Millie. Especially with a history of DKA.
Good luck with Lantus.
Miggins
Member Since 2021
Hi BhoomaHi Karen!
Welcome to the LBL forum! Glad you were able to finally make the switch to Lantus.
Link to your first post in the Main Forum: https://www.felinediabetes.com/FDMB/threads/introduction-from-long-time-lurker.251964/
Btw, what syringes are you using? 8.5mm on the callipers for 1U??!! It's usually anywhere between 1mm and 1.6mm per unit.
The Lantus depot take a week to build. Is your vet guiding you wrt dosing? These are the dosing protocols we follow here:
Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)
Since you're feeding LC wet and can get enough tests an aggressive protocol like TR may be better for Millie. Especially with a history of DKA.
Good luck with Lantus.
Hope you are well! Thank you for your suggestion about TR. I have been having a read about the two protocols but am still undecided…I keep flip-flopping between the two! My vet doesn't have any experience with Lantus however she was pleased we upped the dose and said we would review her numbers again in 3 days…sounds like TR protocol to me
re the dosing, we are using the BD microfine demi 0.3ml syringes as suggested on here from alldaypharmacy.co.uk. I was taught to measure from the thumb plunger end hence the 8mm+ measurement. I have a template syringe set aside to check against if needs be. I know some people measure the barrel, I just find it a bit tricker to do it that way…and a 6.30am with only a few hours sleep I need everything to be as easy as possible
I’ll have (yet) another read of the protocols and try and make a decision
Take care xx
Bandit's Mom
Member Since 2019
Let me see if I can simplify it for you:
SLGS: You hold a dose for 7 days (unless a reduction is earned). You decrease the dose when the BG falls below 90 mg/dl (on a human meter). The aim of this protocol is to keep the cat in the 90-150 range. This is more suited for caregivers who can't test as much as TR requires. You do a weekly curve with SLGS.
TR is a more aggressive protocol with increases as often as every 3-5 days. Reductions are earned when the BG falls below 50 mg/dl (on a human meter). The aim is to keep the cat in the range of 50-100 (which is the normal BG range for cats). To follow TR, you would need to get at least one more test per cycle in addition to the pre-shot one i.e. 2 tests per cycle or 4 tests per day. You would also need to be feeding only LC canned food and no dry food.
TR helps you go up the dosing ladder faster and hold doses where the cats sees numbers in the normal range (50-100 mg/dl on a human meter).
Miggins
Member Since 2021
thanks Bhooma! That’s a really good explanation. I am going to go with TR. I really need to do everything I can to get her BG down. She is at +9 but reading HIGH already. She drinks and pees a lot. Plus she keeps having pee accidents when she is asleep because her BG is so high…it is not nice for her (or me or the furniture).
My concern is she bounces…a lot!! Can TR help with that? Also increasing dosing that fast, does that mean the “ideal” dose can be missed? My understanding is that Lantus takes a while to build up the depot. This was part of the reason I wanted her on this was to have this extra “bank” of insulin her body could use as she burned through Prozinc so fast.
Sorry for the questions I just want to do the right thing for her xx
Bandit's Mom
Member Since 2019
Some kitties are bouncier than others. What helps bouncing is for them to get used to lower numbers. TR will help in that, you can increases doses faster to take her to those good numbers.
Oliver used to bounce to blacks - took him 5-6 months - but he's now flat:
https://docs.google.com/spreadsheet...mWq-niJyfTd030_bh2xLOMA0GAk3GgwWzjpzk/pubhtml
The intial Lantus depot takes a week to build. So I would recommend you hold the the 1U dose for 4 days at least (till 16/9) unless Millie earns a reduction before then!
After the initial depot builds, it takes 4-6 cycles to adjust to changes. By increasing in multiples of 0.25U instead of whole units and by getting enough tests to see how low the BG goes at each dose, you ensure that you don't bypass a good dose. With TR, you hold each dose at least 6 cycles - when you start seeing nadirs below 200, you hold the dose for 10 cycles.
Feel free to ask as many questions as you want!
Miggins
Member Since 2021
Some kitties are bouncier than others. What helps bouncing is for them to get used to lower numbers. TR will help in that, you can increases doses faster to take her to those good numbers.
Oliver used to bounce to blacks - took him 5-6 months - but he's now flat:
https://docs.google.com/spreadsheet...mWq-niJyfTd030_bh2xLOMA0GAk3GgwWzjpzk/pubhtml
The intial Lantus depot takes a week to build. So I would recommend you hold the the 1U dose for 4 days at least (till 16/9) unless Millie earns a reduction before then!
After the initial depot builds, it takes 4-6 cycles to adjust to changes. By increasing in multiples of 0.25U instead of whole units and by getting enough tests to see how low the BG goes at each dose, you ensure that you don't bypass a good dose. With TR, you hold each dose at least 6 cycles - when you start seeing nadirs below 200, you hold the dose for 10 cycles.
Feel free to ask as many questions as you want!
thank you!! It makes total sense. Oliver’s numbers are great now, but I can see what you mean about bouncing…he was worse than Millie!
So TR it is then!! Let’s get this cat regulated
Hello and welcome to you and your bouncy girl.
A note on the spreadsheet, the US tab doesn't translate "Hi" or "High" to anything, so you have to go in and manually change the US tab in that case. I had to do the same with my bouncy one.
Another thing that causes bounces, besides hitting lower numbers than they are used to, is fast drops. Millie seems to like to drop a lot at the beginning of her cycle. What times are you feeding her? Sometimes we can give a small meal or snack 1/2 or so before onset, and slow down those drops which some fresh carbs on board.
A note on the spreadsheet, the US tab doesn't translate "Hi" or "High" to anything, so you have to go in and manually change the US tab in that case. I had to do the same with my bouncy one.
Another thing that causes bounces, besides hitting lower numbers than they are used to, is fast drops. Millie seems to like to drop a lot at the beginning of her cycle. What times are you feeding her? Sometimes we can give a small meal or snack 1/2 or so before onset, and slow down those drops which some fresh carbs on board.
Is this what your vet showed you? Just wondering where you learned this? We heard about a FB group that was telling people to measure from the plunger and I did a few experiments. With the "bounciness" of the plunger when you press it in, I got quite a difference both between syringe manufacturers and within syringes from the same manufacturer, syringe to syringe. I found it a lot less accurate than measuring what is actually in the barrel.
Miggins
Member Since 2021
Hi Wendy! Thank you for the warm welcome.
I was aware that the US tab didn’t register High. I thought I had changed them. From what I am seeing on the US spreadsheet they are saying High and are coloured black. Are you seeing something different? Perhaps you can check for me when you have a moment and let me know. I want to get everything right ASAP. Thank you!
Millie bounces due to not liking drops and/or not liking where she drops to. She gets feed about 15 mins before her shot, 20 mins after her shot, about another hour after that, then again at 2 hours. She basically gets fed whenever she wants, food is left out for her to graze and i am at her beck and call whenever she is hungry. I also have a timed feeder we use overnight and when we pop out. When she was on Prozinc I tried “feeding the curve” with slightly higher carb food at around on-set and it made no difference to her bouncing. This has always been an issue. I have tried up to 5% carbs food, maybe I should go higher carb. Perhaps you might be able to advise me? I would welcome your thoughts.
interesting feedback about the plunger/calliper experiment you conducted. Both my husband and I shoot Millie so I need something both of us can replicate and is easy to do, particularly at 6.30am and not much sleep. I have watched the videos about dosing with callipers after I started with plunger technique but the notes say “If you are currently using calipers, do not change your measurements based on the info below. Consistency is most important so stay with what you have calculated and been using”. I don’t know what to do now? I’m now worried we are not doing right by Millie’s dose. Should I change or stay as we are?
The US tab is now showing "High". When I looked at it earlier, it couldn't translate the value. Maybe I looked at it before you changed it. Regardless, all good now.
As for carbs, you might want to see if an experiment with 7-9% carbs would slow her down more. It's still LC and a lot of cats actually do well with it. Doing the absolutely lowest carbs is often not the answer.
As for calipers, try (in the PM or during the day when you are more awake), measuring the dose the way you are now, and then with that loaded syringe, measure the barrel from the end where the plunger stops. Try that on a couple different syringes - you can always load a used syringe with coloured liquid such as tea or juice, and see if you get a consistent measurement for insulin dose. Call it an experiment. I'd be curious to see what you find. If it is consistent, then no problem and carry on the way you are.
As for carbs, you might want to see if an experiment with 7-9% carbs would slow her down more. It's still LC and a lot of cats actually do well with it. Doing the absolutely lowest carbs is often not the answer.
As for calipers, try (in the PM or during the day when you are more awake), measuring the dose the way you are now, and then with that loaded syringe, measure the barrel from the end where the plunger stops. Try that on a couple different syringes - you can always load a used syringe with coloured liquid such as tea or juice, and see if you get a consistent measurement for insulin dose. Call it an experiment. I'd be curious to see what you find. If it is consistent, then no problem and carry on the way you are.
Suzanne & Darcy
Member Since 2020
Welcome to this forum, Karen and Millie. She sure is bouncy isn't she. You must have been happy to see a blue in there! That's some progress. I assume you are testing for ketones with these high BG numbers and the July DKA. You might want to add a column on your spreadsheet for ketones. It makes it so much easier to track when the numbers are not buried in the comments. Good luck on the Lantus!. You're like me. I started with Vetsulin, then ProZinc, then Lantus, and finally Levemir.
You're in the right place to get all the help you need.
You're in the right place to get all the help you need.