Back after 3 years remission - question on dosing

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milo

milo

Member Since 2011
This forum helped me get Milo into remission 3 years ago and everyone was wonderful. I am sad to say Milo has high numbers again (Sneaking hard food from my daughters cat dish over several months may be the culprit) and I am starting him back on Lantus. The vet wants me to start out with 3 units twice a day, his numbers are in the 400's.. does this seem ok or does that seem too much? Also I still have my old spreadsheet in here should I upload a new one or just use that? Any advise will be helpful!
Thanks,
Jennifer
 
looks like the link in your signature line is broken.

Did you follow Tight Regulation Protocol when you were on before, or Start Low Go Slow?

3u seems too high to me, but it would help to be able to see what kind of doses he had before. Did he get up to 3u before?
 
Yes looking at his old spread sheet it seem at times he was, but I remember the start low do slow rule, and I think I did change it to lower after being advise to do so, it made me more comfortable as well. I forgot how to do all this and reload my spreadsheet etc... so I am following the instructions on that so hopefully I will have it figured out by tonight. I'm waiting for the prescription to be done so I can get him started tonight, do you think I should wait till morning?
 
ok, must be some other Jennifer's Milo.

Can you copy the link from his ss and just post in here in the body of the message so we can peek at it?
 
oh, and I'd keep the same spreadsheet. You can open a new tab if you want for 2015, or if the old ss isn't too long, you could just do a line across it and keep going for 2015.

Will he have access to dry food now?
 
I will make sure he has no dry food near him as I start this again....what does would you recommend I start with, if you are aloud to advise that?? Maybe the 2.5 again or lower?
 
Sure, anyone can suggest a dose - it's up to you to ask questions and decide if you want to follow someone's suggestion.

Couple of things. When a cat has come back out of remission, it's good to try to figure out why. It could just be the dry food he got into - that can be too much of a burden on a pancreas. Once they are diabetic, the cat is always diabetic, just diet-controlled. Sometimes teeth issues - infections or gingivitis can be the cause of a cat coming back. Bladder infections are another possibility. Did your vet do a thorough exam?

Most of the time with a cat back out of remission, the caregiver will find that they have to be more aggressive with the dose if the goal is to get the cat back into remission again. From Milo's ss, it looks like it took him about 2.5u to see action, although he may have been started at too high of an initial dose.

If you want to follow the SLGS method, and there is no dry food in the picture, it would suggest you start at 0.5u per shot. Then doses are held for a week before being adjusted. Does that sound like what you want to do?

Starting Dose
  • 1u BID if kitty is not on a wet/canned low carb diet
  • 0.5u BID if kitty has been switched to a wet/canned low carb diet
  • If the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration
  • Generally, shots are to be given 12 hours apart.
Hold the dose for at least a week
  • Unless your cat won’t eat or you suspect hypoglycemia
  • Unless your kitty falls below 90 mg/dL (5 mmol/L) if kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours
Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet.

  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
  • As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], do lengthen the waiting time between dose increases. If you decide to change another factor (e.g., diet or other medications), don't increase the insulin dose until the other change is complete (but do decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change). Don't be tempted to rush the process along by increasing the dose more quickly or in larger increments-- no matter how high your cat's blood glucose is! Rushing towards regulation will cost you time in the long run, because you may shoot past the right dose.
Lather, Rinse, and Repeat!
​
 
by the way, can you edit your signature line to fix the broken ss link, and also add "SLGS" and what kind of glucometer you are using? Also any other important info, like that he's back out of remission, or if he has any other chronic issues, etc.

That way anyone trying to help you has the essential info at hand. Most people are doing that instead of doing a profile now.
 
He did have a bad uti, which he is taking clevox for 10 days right now and the vet did say his gums are inflamed, I am going to use reli on again but I am having trouble finding strips for them our walmart never stays stocked with them ugh!!
 
If you've got a Confirm or Confirm Micro, you can order test strips from ADW for the Arkray USA Glucocard 01 or 01 Mini. They're identical.
Or order online from WalMart.
 
Yes they said he def needs that...Thanks for the info about the confirm micro I will give it a try!
I'm not sure what you mean by edit signature etc... sorry can u advise more??
 
If you go to the top of the page and click on your user name on the right hand side a box will appear one of the options is signature. If you click on that you will be able to change the info in your 'signature' which is the info that appears under every post you make. At the moment yours is just the broken link to Milo's ss
 
What all should be posted in there.....sorry it has been a while since I have been on here...I'm very green but thankful for the help..right now it just has that googledoc.com/spreadsheet stuff in it right now and even when I open that it says not found..so I need to upload a new spreadsheet? And add what other kind of stuff??
 
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