9/23 Sulls starting Lantus tomorrow - starting dose advice?

Hello and welcome here. A couple things determine his starting dose. First, take a look at the yellow starred Sticky Notes at the top of this forum. A lot of info in there, don't worry about getting it down the first read. :) The Sticky Note on Dosing Methods has some ideas on what dose to start with. If he's never been on insulin before, you have one decision to make first, and that's whether you want to follow the Tight Regulation Protocol for dosing or the Start Low Go Slow Method. It's really up to you, your lifestyle and goals. Since Sullis is just eating wet food, you can choose either one. If you want to follow TR, we'll need to know his weight.

Can you tell me a little bit more about how Sullis was diagnosed?
 
Wendy&Neko said:
Hello and welcome here. A couple things determine his starting dose. First, take a look at the yellow starred Sticky Notes at the top of this forum. A lot of info in there, don't worry about getting it down the first read. :) The Sticky Note on Dosing Methods has some ideas on what dose to start with. If he's never been on insulin before, you have one decision to make first, and that's whether you want to follow the Tight Regulation Protocol for dosing or the Start Low Go Slow Method. It's really up to you, your lifestyle and goals. Since Sullis is just eating wet food, you can choose either one. If you want to follow TR, we'll need to know his weight.

Can you tell me a little bit more about how Sullis was diagnosed?
Click to expand...

Thank you for the reply and the welcome. :-)
Not sure about the type of protocol to start him on. I'll try to decide tonight.

He's currently 18.2lb.

Diagnose: we noticed that he started to loose weight (he was at about 23lb before). That was the main reason we decided to take him to a vet. We also noticed that he drank more water than usual but didn't connect the dots at first. He doesn't show any other clinical signs of diabetes. At the vet his BG was 475 and he had 1 keton in his urine. Before diagnoses he ate dry food and FF with gravy (! I now know how irresponsible that was). He was diagnosed about 2 weeks ago. We changed his diet immediately but didn't start him on insulin until now. We did a curve you see couple of days ago and got a prescription from the vet today. Today at the vet he tested 389 on pet meter in the morning. Vet recommended to start him with 2 units x2 day.
 
Are you still testing for urinary ketones? You can do that at home and a good idea with some of that in the recent past. You can buy ketostix or equivalent at any human pharmacy. Tips to catch and test a urine sample

18 lbs - well he does look like a fluffy Maine Coon type in his picture! I guess I should have asked what his idea weight is. If it's 18 lbs, then 2 units is a good starting dose if following Tight Regulation. If following Start Low Go Slow, it would be 0.5 units. Hence the need to know what dosing method you'd like to follow.

None of worry about what we did in the past, what is important is what you do now. :bighug: And you've got some gravy FF around for low number emergencies.
 
Welcome to the LB&L forum...the best place you never wanted to be!

Nice job on your Title, Spreadsheet and your signature! Even your avatar is adorable! Thank you so much for getting all your ducks in a row :)

I know this is an upsetting time for you and Sulls...so many things happening all at once! But you're among friends now, so take a deep breath and start reading all those stickies...it's a lot of reading, but as Wendy suggested, try to decide which dosing method you're most comfortable with to start - you can always change after you've had a chance to get your feet wet here...

When you have a chance, look around on the forum and look at individual condos and their spreadsheets. I learned so much by looking at what was going on with other kitties, the good, bad and the ugly...it's all out there. I found it helpful as it helped me learn to do what when situations arose where I was unsure of next steps. You'll find out quickly that so many of us were in the same boat as you - we all had our first day and then lots of things to learn about along the way.

Best of luck to you and Sulls as you begin this journey - remember it's a marathon, not a sprint...takes a little time to get it all together and help your kitty to feel better! He'll be back to himself in no time at all.

:bighug:
 
Wendy&Neko said:
If it's 18 lbs, then 2 units is a good starting dose if following Tight Regulation.
Click to expand...
Sorry to cut in but can you explain the weight importance for TR to me? When I look at a SS of yellows and never being on insulin I wouldn't ever consider starting at 2u. :confused: Trying to understand how that works!
 
Tight Regulation (TR) is based on a published research protocol. Initially, they used the same method for calculating a starting dose as they used in the vet hospital at University of Queensland where one of the authors directed the program. They subsequently realized that for the average person who wasn't monitoring their cat 24/7, they needed a more moderate dose. In part, TR is a more aggressive approach to dosing with the goal of getting the cat tightly regulated or in remission as quickly as possible. The current method for calculating the initial dose is: initial dose = 0.25 x ideal weight in kilograms.
 
I guess I'm wondering why weight was involved in the study for deciding starting dose. Sometimes big kitties only need a little bit of juice before heading into remission, and other times little kitties need big doses. ECID. Wouldn't it be safer to start low, instead of giving too much simply because the cat weighs a lot? I know I must be thinking in terms of SLGS so I'm just trying to wrap my head around the logic of using weight to determine dose instead of BG values.
 
And also to kinda piggyback off that.... when choosing a protocol, does it matter if cat is starting off with a "yellow" curve vs kitties that are starting off in a red//purple? Just trying to decide what is the best approach for Sulls (TR or SLGS) since he is in the yellow zone even before starting lantus.
 
Hi @Aliona! So good to see you here after following your efforts to get a lantus prescription on FB! You are off to a great start by being here! I think the main difference between TR and SLGS is how often you can test and how quickly you will adjust insulin dosing, so a cat's initial blood glucose levels may not matter. Best of luck to you and Sulls!
 
The decision of TR vs SLGS doesn't take into consideration the numbers they have at the start. I've seen a cat in yellows at diagnosis top out at around 10 units. Starting that cat at a lower dose and SLGS would have taken way longer to get her into good numbers. ECID = every cat is different. What TR allows you to do is to increase faster and by larger amounts if the numbers are higher. And for clarity, TR is the only published protocol. SLGS is a method developed here over years. Both dosing methods have been used by many caregivers over the years.

What you have to consider when choosing a dosing method is a few things. Your ability to monitor, your comfort level with testing at least 4 times a day are two of those things.
 
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