About to Start the SL, GS method--somewhat confused on starting dose

Status
Not open for further replies.
Arkali

Arkali

Member Since 2018
Hi, everyone! I'm new to the group. Gypsy was diagnosed last Monday with diabetes. Her blood sugar at the vet's was at least 700 (that's as high as the vet's meter goes). She stayed at the vet until Wednesday evening and has been home since. The vet's instructions:

Give 2u twice daily. If home testing (I am), then check glucose before food and give insulin (scale below), feed, and then check sugar again about thirty minutes later. Twice daily, about 12 hours apart.
Scale:
400+ = 2u Lantus
250 - 400 = 1u lantus
Under 250 = no dose

I have switched all my cats, including Gypsy, to Fancy Feast classic pates, the non-fish ones. Gypsy and Buddy are fine (though still holding out a bit for dry food). Emmy is being a pain, though I did get her to eat last night. Whether or not she'll eat tonight remains to be seen :-p

ANYWAY, my question (sorry it took me so long to get to it :-) ): What dose should I start at? Vet said 2u. The SL, GS info page says 1u, but if the cat is on wet food then half a unit? I'm actually thinking I'll go one unit because my syringes don't have the half-unit measurements (live and learn--I'll try to get new syringes next week). Anyway, would y'all suggest 2u (vet's instructions) or 1u (closer to SL, GS method)?

Thank you!

PS: Very slim amount of data is in Gypsy's spreadsheet--she's only been home since Wednesday night. But I do have it set up. Also, she's supposed to go back to the vet between the next week to two weeks for her curve (I'm thinking the 13th).
 
Thanks, @Olive & Paula -- I replied over there too LOL I'll move my Lantus questions to here in case they help someone else, at least they'll be in the right area. I think I'll go for the happy medium of starting at 1u BID. That's closer to what the vet prescribed, but more importantly, that's how the syringes are marked and I'm (at this point) less concerned with what the vet said and more concerned about being able to accurately tell what dose I'm giving her.
 
Hi there Arkali an welcome to the Lantus, Basaglar and Levemir group. This is the best place you never wanted to be. Lots and lots of experience here with diabetic kitties.

First, I am so glad that you are home testing. That is very very important to keep Gypsy safe. If you could get some test in around the +4 -+7 time frame, which is usually nadir for most cats, but not all cats, and that will help you to find how low the Lantus is taking her. Since we base the dose on the nadir with some consideration to the nadir, that will help with dosing.

And that said, Lantus does not do well working a sliding scale as your vet instructed you too. The in/out insulin like ProZinc can be dosed that way but not Lantus since it is a depot insulin and the depot has to get established. Read the stickie at the top of the Lantus group on What is the Depot. And that will help you understand it a little better. We stay with a dose for at least one week ( of course if she were to go below 90 , you would decrease) if you are following SLGS and we raise and lower doses in increments of .25 units. So do, get the U100 syringes with 1/s unit markings.

If you can test at pre shots and at least once during the mid cycle you could follow Tight Regulation since you have her off the dry food now. That would enable you to get her in better numbers faster. Just a thought.

Also, it's not necessary to let the vet do the curve as you can do it at home :
1. Save $$
2. Gypsy won't be stressed out and have higher BG's at the vet office and her numbers will be truer and not stress induced. When they go to the vet their BGs can raise as much as 100-150 points from the stress and then you would be determining a dose on an inflated number.

Also, since most kitties tend to go lower during the PM cycle, it is important to get at least a before you go to bed test in.

Since she just recently switched to low carb wet food, her BG's could really drop so please be vigilant in testing. Your not shot number would under 150. Between 150 and 200 (8.3-11.1 mmol/L), you have three options: a.) give nothing; b.) give a token dose (10-25% of the usual dose); c.) feed as usual, test in a couple of hours, and make a decision based on that value.

Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.

Keep asking questions as that is how we all learn.
 
Ugh. I just realized something I've been doing wrong--my syringes are marked for 1/2 units. Which I was thinking was a full unit. :headdesk:
 
Status
Not open for further replies.
Back
Top