BG low for first time NEED Dosage Help again AMPS 218.

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Charia & Hexie

Charia & Hexie

Member Since 2023
I performed a BG Curve today (my 4th at home/using AlphaTrak3) and she got some low numbers, see below. She didn’t get hypoglycemic as far as I could tell. She was alert, walking and even got her to play. I didn’t know not to feed her if I need dosage help and haven’t started daily testing yet. I for sure am not giving her the 6 units she’s been on tonight. But I need advice on if I should give a lower dose or none until I speak with vet. I do plan on getting human meter and start testing daily/use spreadsheet. I can provide previous BG Curve results and dosage at that time if it will help.

BG Curve 08/23/23
Reading Time Notes
377 7:28am Before food & insulin
- 7:40am Set out 1/2 can. Ate 1-2 tablespoon right away the rest over the next few hours.
- 8:10am 6 units insulin given
245 10:06am
78 12:09pm
57 2:09pm Acting normal, alert, walking normal, played.
139 4:13pm
191 6:10pm
- 7:35pm. Ate 2 tablespoon of canned food
328. 8:27pm
 
Charia & Hexie said:
I can provide previous BG Curve results and dosage at that time if it will help.
Click to expand...

Yes, any data can be helpful but what will be the most help will be the daily testing. Cat's change things fast sometimes so something that happened 2 weeks ago has little to do with what's going on now.

Since you're using Vetsulin, dropping below 90 means she's earned a reduction so if she's high enough at the next shot time (since you skipped), you'd reduce to 5.75

I haven't gone back to read any other posts you might have made, but being on 6U after only 3 months from diagnosis is a VERY high dose. Most cats never go over about 3-4 unless they have a high dose condition like acromegaly or IAA.

If you need some help setting up the spreadsheet, I'd be happy to do it for you. It really is one of our most useful tools and without it, we can't give you the best advice possible. Just send me a private message by clicking on my name and choose "start conversation".
 
To remove the 911, go to your original post here and find "Thread tools". Click there and you'll be able to edit your subject line by choosing "No Prefix"

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The 328 is her "bouncing". Bounces happen when 1. they drop too low, 2. they drop too fast, 3. they drop into numbers their body hasn't been for a long time (or any combination of all 3). In your case, I'd say she got all 3!

By doing any one of those things, the liver will release stored sugars and hormones to bring the glucose back up. (and it's not very good at just doing it a little). It can take up to 6 cycles (3 days) for those sugars and hormones to clear out and you start to see numbers that are more indicative of the dose you're giving with the reduction.

You could probably go ahead and shoot tonight IF you're able to move your shot times over the next few days. You can move by 15 minutes per cycle or 30 minutes per day until you're back to the shot time that you want but do NOT give 6U. Personally, I'd probably drop to 5.5. I'm really concerned about how quickly you're dose has been raised.
 
For sure wasn’t giving 6 again but was unsure what or if I should even give it. I can move time back as you suggested and give her some tonight. The vet started her on 1 unit and we’ve been doing BG Curves every two weeks and increased 1 unit each time since numbers were still high. The curve 2 weeks ago we finally got a few numbers under 200, this curve below. We have retested for UTI and bloodwork during to make sure that wasn’t raising her numbers. My vet has some diabetes experience but I don’t think a ton however she is receptive to my suggestions (which I found here). I’m hoping I can get into town tomorrow to get a human meter from Walmart and to start my spreadsheet. I’m chronically ill so this has all been overwhelming and extremely difficult but she’s so worth it.

BG Curve from 08/07/23
Reading Time Notes
444 7:29am before food & insulin
- 7:35am gave 1/2 can food, takes hours to eat all
- 8:00am insulin shot 5 units
305 10:12am
184 12:08pm
- 1:00 pm gave 1/4 can food
160 2:05pm
219 4:08pm
314 6:10pm

BG Curve 07/24/23
TIME - GLUCOSE READING
7:23am - 597
7:30am - Ate food (not all she grazes)
8:00am - 4 units of Vetsulin
10:04am - 362
12:03pm - 238
2:06pm - 206
4:03pm - 291
6:05pm - 420

BG Curve 07/10/23
8:00am - 446 (tested before first meal)
8:32am - 598 (tested after eating just before insulin at 8:35am)
10:42am - 334
12:38pm - 262
2:36pm - 300
4:40pm - 495
 
Charia & Hexie said:
The vet started her on 1 unit and we’ve been doing BG Curves every two weeks and increased 1 unit each time since numbers were still high.
Click to expand...

Yeah you were increased by too much, too quickly. Most increases should be in 0.25 increments. Any faster and you can miss what could have been a purrfect dose.

Hopefully you'll be able to get the Relion Premier meter ($9), 100 strips for the Premier ($17.88), lancets (Relion THIN, not ultra thin or microthin) and if you feel like you need it, a lancet device. Most of us freehand the lancet because we can see better where we're poking and the "click" the device makes can startle a lot of cats too.

It'd be even better if you could get your vet to change your insulin to Glargine (name brands Lantus, Basaglar, Semglee) or ProZinc. They are much better choices for cats. Vetsulin is more meant for dogs. Only in the US is it called Vetsulin. The rest of the world calls it Caninsulin (note the "canin" prefix). It tends to hit hard and fast and then wear off before the next shot is due. Glargine and ProZinc are more gentle and last longer.

Might be helpful to show your vet this (or send him/her the link). It's the AAHA guidelines for diabetes, and this is the page specifically about cats. https://www.aaha.org/aaha-guidelines/diabetes-management/treatment/cats/?

Don't tell them you learned it in an online group or forum. A lot of vets specifically tell their clients not to believe anything they read on the internet but the AAHA is intended for veterinarians. I told my vet that I was just doing some research on feline diabetes and happened to come across an article from the AAHA on treatment for diabetes in both dogs and cats and wondered if there was a reason we couldn't try one of the recommended types. If you get a bunch of blow-back, you may need to find a different vet.
 
Bron and Sheba (GA) said:
Hi Charia and Hexie
Do you have a spreadsheet? It would be helpful if you could set up one. We can help set it up if you like
Here is the link Help us help you
Click to expand...
I don’t have a spreadsheet yet as I have not been testing daily. My vet said it wasn’t necessary until we got her regulated. I am ordering the Relion Premier so I can afford to test daily as I only have an AlphaTrak 3. Chris (commenter above) is helping me set it up.
 
Charia & Hexie said:
I don’t have a spreadsheet yet as I have not been testing daily. My vet said it wasn’t necessary until we got her regulated. I am ordering the Relion Premier so I can afford to test daily as I only have an AlphaTrak 3. Chris (commenter above) is helping me set it up.
Click to expand...
Great. I can never understand vets who say you don’t need to test until the cat is regulated. That just doesn’t make sense. The testing takes the guesswork out of it and it is far safer.
 
@Charia & Hexie
If you do switch to lantus/ genetic which most members use the generic because lantus is very expensive in the US just tag me and I can give you information about the generic lantus and where to get it, plus you would need to get different syringes U-100 with half unit markings

When I tap on your picture then tap on your profile I get this
Feline Diabetes Message Board - FDMB - Error
This member limits who may view their full profile.

Just wanted to let you know in case we need to find any of your previous posts
I think you have to change a setting
 
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Diane Tyler's Mom said:
@Charia & Hexie
If you do switch to lantus/ genetic which most members use the generic because lantus is very expensive in the US just tag me and I can give you information about the generic lantus and where to get it, plus you would need to get different syringes U-100 with half unit markings

When I tap on your picture then tap on your profile I get this
Feline Diabetes Message Board - FDMB - Error
This member limits who may view their full profile.

Just wanted to let you know in case we need to find any of your previous posts
I think you have to change a setting
Click to expand...

I think I fixed the profile issue. Changed them all to members only on privacy. This is my first post.
 
I’ll be getting the Relion meter sometime today. Until then I am using the expensive AlphaTrak. That is also why no spreadsheet with these numbers. I will be using the spreadsheet as soon as I get the Relion.

I could use more dosage help this morning. I am so nervous she’s going to go hypo. Her number from the last few days including the last BG Curve, using AT3, are below. I lowered her dose to 5.5 since she got so low. Should I still give that this morning. Her AMPS was 218.

8/23/23 BG Curve
377 7:28am AMPS
- 7:40am Set out 1/2 can. Ate 1-2 tablespoon right away the rest over the next few hours.
- 8:10am 6 units insulin given
245 10:06am
78 12:09pm
57 2:09pm Acting normal, alert, walking normal, played.
139 4:13pm
191 6:10pm
7:35pm. Ate 2 tablespoon of canned food (rest eaten overnight)
328. 8:27pm
- 9:45pm ate more
- 10:00. 5 units given
08/24/23
396. 7:14am AMPS
- 9:00am food given
- 9:30am 5.5 units given
131. 3:49pm
326. 8:57pm PMPS
- 9:00pm food given
- 9:30pm 5.5 units given
08/25/23
218. 8:16am
 
This morning I stalled and restested. She was going up so I fed and gave her the shot (30 mins after eating).

I got the Relion meter and will be using that from now on. So I will now be using the spreadsheet.
 
Sorry no one got back to you earlier. Let us know if you have any trouble with setting up the SS.
Great you got the ReliOn meter.
You are giving a large dose of Vetsulin… can you tell us how you arrived at that dose.
I’ll tag @Suzanne & Darcy about dosing with Vetsulin.
Have you thought about swapping to a better insulin such as Lantus?
 
Bron and Sheba (GA) said:
Sorry no one got back to you earlier. Let us know if you have any trouble with setting up the SS.
Great you got the ReliOn meter.
You are giving a large dose of Vetsulin… can you tell us how you arrived at that dose.
I’ll tag @Suzanne & Darcy about dosing with Vetsulin.
Have you thought about swapping to a better insulin such as Lantus?
Click to expand...
Yes it sounds like she’s on a high dose. This was per my vet’s instructions. She started her off a 1 unit and doing a curve every two weeks then increased by 1 unit each time. 6 was the last increase and was too high, so per someone here I reduced to 5.5units.

Today her AMPS was 218 (AT3 meter), I stalled and an hour later her BG was 266 (AT3) so I went ahead with the 5.5 shot. I checked it again when I got the Relion and at +5.5hrs she was down to 72. Doesn’t that merit a .25 decrease this evening? I’ll be testing then feeding in about an hour.

I would like to switch insulins and need to speak with the vet. She mention once that the other insulins are more. Where is the best place to get insulins? I would also like to switch to the highly suggested can food here instead of the expensive prescription DM.

The member above, Chris is helping me set up the spreadsheets.
 
Bron and Sheba (GA) said:
I will tag @Diane Tyler's Mom asshe can tell you where to buy cheaper insulins
Click to expand...
@Charia & Hexie
Lantus is the major brand name glargine the USA you can get generic/biosimilar glargine at very reasonable prices using GoodRx coupon. Most members use the generic because Lantus is to expensive.
https://www.goodrx.com/lantus?label...d-pens-of-100-units-ml&quantity=1&slug=lantus
Make sure that the Match your prescription pull down menue says generic glargine 1carton of 5 3ml pens.
There is no wait time test, feed, give insulin
Lantus usually doesn't kick in until 2 hours after the shot
Let us know if the vet writes the script for you because you will need U-100 syringes with half unit markings , I can tell you which ones you can use
We buy the pens but use the syringes to draw out the insulin because if you use the pen you can only adjust by full units ,we adjust the doses by 0.25 units


Also
The 5 pens will last about a year, we use the pens just like a vial, you would just insert the syringe it the gray rubber stopper on the pen and draw out your insulin
Its generic lantus



Or this one also

I see some members will call CVS, Rite Aid, Costco, Walgreen's, to get the price for 5 pens
Posted by another member
One members posted this
. I paid $175 for a box of 5 pens at Walmart pharmacy, but GoodRX coupon says you can get it for around $90 if you have a Rite Aid pharmacy near you.

Just call around for the best price

A member just posted this
Allie was using the Lantus and I just switched to the generic and using the GoodRX I got 5 pens for $81.30 at Walgreens. GoodRX has a 1-800 number to assist you in using their services to get your pets prescriptions filled if the pharmacy gives you anyissues.
 
What is the best procedure to switch insulins? Do you just start all over at the lowest dose? I also want to switch her food, should this be done at the same time?

Unfortunately no rite aid but Walgreens shows at 80 now. Now to convince my vet.
 
Charia & Hexie said:
What is the best procedure to switch insulins? Do you just start all over at the lowest dose? I also want to switch her food, should this be done at the same time?

Unfortunately no rite aid but Walgreens shows at 80 now. Now to convince my vet.
Click to expand...
Have you private messaged @Chris & China (GA) to set up your spreadsheet , It would be much easier for members to look at your SS than going looking at the BG's you have posted above and we don't use times because we are all in different time zones
I see you are feeding Purina Pro Plan DM wet which is 6% carbs which the carbs are fine
Most of us feed Fancy Feast Pate or Friskies which are 6% and under
I'll give you the food link so you can look at it
I can tag a few Vetsulin users about your questions
@Suzanne & Darcy
@JanetNJ

Here's the food chart
https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/

About the spreadsheet
AMPS - means AM Pre Shot the first test you take in the AM ,you need to withhold food 2 hours before testing so it's not food influenced

Units is where you would put how much insulin you gave
+1 is one hour after giving insulin if you were to test then that's where you enter his _BG number
+2 two hours after giving insulin. ditto
+3 and so on until you get to PMPS - PM pre shot withhold food 2 hours before testing

+1 same as you do for AM cycle

We don't give times because we are all in different time zones that's why we use the + numbers


If you want to try and set it up here the link, if you need help just ask we have a member who will be glad to set it up for you
https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

I see @Chris & China (GA) said above
If you need some help setting up the spreadsheet, I'd be happy to do it for you. It really is one of our most useful tools and without it, we can't give you the best advice possible. Just send me a private message by clicking on my name and choose "start conversation".
 
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Hi. I would love to see a spreadsheet with some numbers from the previous curves put in there. I was reading about your recent preshot and your question (from this morning or yesterday?) and I can’t tell if that’s the lowest preshot number that you have had? You’re doing a great job. I hope you have given another reduction in dose by .25 units since your kitty hit 72.
 
Chris is helping me with it today, it’s almost done and I’ll get the numbers in today too. I’ll post here when I have the spreadsheet filled in.

The lowest I’ve seen was on the last curve, 08/23 at 6 units. With the AlphaTrak 3 her nadir was 57. So per instructions from here I took her down to 5.5units. And when she had a reading of 72 with the Relion yesterday so we came down another .25 units. I’ll do a spot check in a few hours and her PMPS as well. I will do a bedtime test when I can.
 
Charia & Hexie said:
Chris is helping me with it today, it’s almost done and I’ll get the numbers in today too. I’ll post here when I have the spreadsheet filled in.

The lowest I’ve seen was on the last curve, 08/23 at 6 units. With the AlphaTrak 3 her nadir was 57. So per instructions from here I took her down to 5.5units. And when she had a reading of 72 with the Relion yesterday so we came down another .25 units. I’ll do a spot check in a few hours and her PMPS as well. I will do a bedtime test when I can.
Click to expand...
Yes. Those reductions were earned for sure. I was thinking of the 218 preshot number and whether that was the lowest preshot you ever had. With vetsulin and ProZinc sometimes it’s better to shoot a reduced dose if you have an unexpectedly low preshot - most especially when you don’t have the data to know how your cat will do on that dose when starting with a lower preshot. It’s a safety measure.
 
I put the link to our spreadsheet in my signature. I couldn’t figure out right now how to put just a title not the whole link.

I just tested her again and she’s at 70 again. I’ll retest again when I can.
 
Suzanne & Darcy said:
If she’s at 70 now, I would at least get a +8. And she has earned another reduction.
Please tell me about her eating schedule during the cycles.
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Sorry just got your message. I am disabled with lots of genetic health issues and fighting a bad migraine. I was unable to test earlier. I did my best to keep an eye on her as she was laying on or near me all afternoon. Almost time for her PMPS and I will decrease again by .25. I am also going to set alarm and try and get a test later tonight at least 2 hours after shot. I set out most her food before the shots, with nighttime a bit more and makes sure she eats some before I give insulin. She is a grazer. I give her a small amount mid cycle. I have been giving freeze dried beef liver or salmon treats after testing.

I'm doing my best with my health. And even had to stop some of my treatments and meds to afford her meds, food and supplies.
 
Charia & Hexie said:
Sorry just got your message. I am disabled with lots of genetic health issues and fighting a bad migraine. I was unable to test earlier. I did my best to keep an eye on her as she was laying on or near me all afternoon. Almost time for her PMPS and I will decrease again by .25. I am also going to set alarm and try and get a test later tonight at least 2 hours after shot. I set out most her food before the shots, with nighttime a bit more and makes sure she eats some before I give insulin. She is a grazer. I give her a small amount mid cycle. I have been giving freeze dried beef liver or salmon treats after testing.

I'm doing my best with my health. And even had to stop some of my treatments and meds to afford her meds, food and supplies.
Click to expand...
Oh that sounds like a tough situation in many ways. I can understand the love you have for Hexie. And I am really sorry that you’re not well and are also battling a migraine. I’m sure your sweet Hexie is a comfort and a joy to you. I am sure we can help you on this journey.
 
I was just checking in on how she did last night. The drop from 395 to 104 in less than three hours is too steep. That will very likely trigger a bounce and you will see a high amps. The way to help prevent that is to (1) test earlier (definitely by +2) and (2) make sure she eats some food at about +2. I know that you said she grazes, but sometimes our cats don’t graze at the right times, if you know what I mean :) So if you test at +2 (and sometimes you need to start earlier at +1 to see if she’s dropping too fast and intervene with a snack to help slow the drop) you can help smooth the cycle with food. You will have to experiment with different carb levels as well to see how much she needs to stay stable and to have a smoother curve overall without steep drops.

I know that you weren’t feeling well especially last night, so I understand that you were doing your best at the time. None of these observations and suggestions are criticisms at all!

Finally, and very importantly, if she’s dropped a lot so early in the cycle, you need to keep testing in order to make sure that she’s not going to keep going and drop into unsafe territory. That low blue (almost green) was not even three hours into the cycle so it’s definitely possible that she kept dropping. I am hoping that you got one or two more tests but just didn’t enter them into the spreadsheet.
 
Suzanne & Darcy said:
I was just checking in on how she did last night. The drop from 395 to 104 in less than three hours is too steep. That will very likely trigger a bounce and you will see a high amps. The way to help prevent that is to (1) test earlier (definitely by +2) and (2) make sure she eats some food at about +2. I know that you said she grazes, but sometimes our cats don’t graze at the right times, if you know what I mean :) So if you test at +2 (and sometimes you need to start earlier at +1 to see if she’s dropping too fast and intervene with a snack to help slow the drop) you can help smooth the cycle with food. You will have to experiment with different carb levels as well to see how much she needs to stay stable and to have a smoother curve overall without steep drops.

I know that you weren’t feeling well especially last night, so I understand that you were doing your best at the time. None of these observations and suggestions are criticisms at all!

Finally, and very importantly, if she’s dropped a lot so early in the cycle, you need to keep testing in order to make sure that she’s not going to keep going and drop into unsafe territory. That low blue (almost green) was not even three hours into the cycle so it’s definitely possible that she kept dropping. I am hoping that you got one or two more tests but just didn’t enter them into the spreadsheet.
Click to expand...
I was unable to test anymore last night. But slept on the couch both due to my health issues but also to keep an eye on her best I could. I gave her regular treats (more carbs) after since I was unable to test again through the night. Unfortunately I am chronically ill with multiple serious issues and have trouble mosey days. I’ve been on disability since my early 30’s. It’s why I didn’t have kids.

And of course she bounced again and was 360 AMPS this morning. With the dip last night, I am assuming she went or would have gone lower, I would decrease by .25 this morning? I am trying to get more night tests as Chris mentioned they go lower at night typically.

I don’t know how to get her to eat more at specific times. I have had to wait to do the shot before cause she won’t eat or eat enough. I started putting the freeze dried treats on top or a little catnip. This helps a little. Typically I see her going back to eat half hour to hour after shot. I’m really thinking this insulin is just not working for her. All her curves she was lowest at the 6 hr or 4 hr mark. I want to get together as much info today that Vetsulin isn’t great for cats and Hexie specifically and speak with the vet tomorrow. I would also like to switch her food.

What is the best way to switch insulins? Like do I start over at the lowest dose? Also should I wait to switch foods or is it best to make both changes at once?
 
If you need to speak to your vet about changing insulin, I'm going to link a paper from the American Animal Hospital Assn. You can print the paper out for your vet. The paper is the AAHA guidelines for the treatment of diabetes. Since 2018, they have been recommending either glargine (Lantus) or Prozinc for the treatment of feline diabetes. Vetsulin has too short of a duration to be effective for treating diabetes in cats given how fast a cat's metabolism is. Vetsulin's "other" name is Caninsulin -- it was formulated for dogs, not cats!

If you have low carb food, other than DM at home, it's fine to start transitioning Hexie to that food. The DM is find when it comes to carbs. It's just a poor quality food for what you're spending. In addition, it is truly not a "prescription" food. The name was changed from diabetic to dietetic management when the pet food manufacturers lost a class action suit for calling their foods prescription. There is nothing medically relevant in the food.

If you start on glargine, you can make a direct switch -- whatever your current dose is you can start at that dose. Some cats do have a marked response to a switch in insulin so you may want to lower the dose slightly. Glargine is very different than Vetsulin. When you get closer to making a switch, we can walk you through what those differences are.
 
The short duration I think is contributing to Hexie’s numbers.

I have the AAHA guidelines ready. Will I be doing the Tight regulation or Slow ones with Lantau generic? I wanted to have that info ready to because my vet was increased by 1 unit. She was receptive to my questions previously and even looked into it further. So I’m hoping if I go in confident with info she may just prescribe the med and just help monitor. If not I will have to order another Vetsulin and look for another vet.

I’ve done her AMPS and a +1 BG. I will be doing a +3 test very soon. She just got into the treats, so is acting a little extra hungry this morning.
 
You typically do not start over at the “lowest” dose. When switching insulins, we take into account what kind of numbers the cat has been getting at it’s current dose. It also depends on which insulin you have prescribed for Hexie.
 
Also, to answer your question about reducing. We don’t recommend reducing based on assumptions that a cat “may” have dropped low, but based on testing. Who knows if she may drop below 90 today, though.
 
I've been trying to get more tests today. Some days I'll only be able to do bare minimum unfortunately. I have trouble taking care of the bare minimum and myself a lot of days. Hexie and my pitbull mix LeeLoo are my babies and keep me going some days.

I did panic with the fast drop so early in the cycle last night. I will try and do better. Her numbers have been over 100 today I'll try to get another BG before her PMPS and will def get another bedtime.
 
Well you have done absolutely fabulous today with testing. Your tests give us valuable data for Hexie. I’m glad you got a break from really low numbers. It wasn’t too bad of a cycle for Vetsulin.
 
Charia & Hexie said:
. Will I be doing the Tight regulation or Slow ones with Lantau generic? I wanted to have that info ready to because my vet was increased by 1 unit. She was receptive to my questions previously and even looked into it further. So I’m hoping if I go in confident with info she may just prescribe the med and just help monitor. If not I will have to order another Vetsulin and look for another vet.
Click to expand...
The method you chose to follow will be up to you
I'll post the link for lantus/genetic ,read all the yellow stickys especially the 2 dosing methods
https://felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/
They will let you know when in increase or decrease is needed
We don't adjust the dose going by the pre shots , we adjust the dose by how low they drop
 
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SLGS: You hold a dose for 7 days (unless a reduction is earned). You decrease the dose when the BG falls below 90. 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. 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.

You could try TR if you are feeding LC wet (and no dry) and if you think that's more testing than you can manage, you can switch to SLGS.
@Charia & Hexie
 
Diane Tyler's Mom said:
Hi Charia can put the date you switched to the Relion meter in your signature and on your SS up top.
Members sometimes don't look at the remarks section on the SS
Click to expand...
Got it changed. Let me know if it’s not easy to understand.


Diane Tyler's Mom said:
The method you chose to follow will be up to you
I'll post the link for lantus/genetic ,read all the yellow stickys especially the 2 dosing methods
https://felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/
They will let you know when in increase or decrease is needed
We don't adjust the dose going by the pre shots , we adjust the dose by how low they drop
Click to expand...
I will read up tomorrow. I want to be as knowledgeable as I can when speaking with the vet. I want to be able to explain what changes and why I want the changes. She’s been our vet for almost 8 years and hope she will listen.

Thank you for explaining them. Sometimes the info on threads is too much at once. It helps when I have a general idea about what I’m reading before I dive down the forum rabbit hole.

Hexie has been on low carb canned food since diagnosis and we weaned her off dry completely within first month.

Should I leave her dose at the 4.75 in the morning or should I changed it since I never should have gone down the last .25? I know with experience and all of your guys help I will get it eventually it’s just a bit daunting.
 
Charia & Hexie said:
Got it changed. Let me know if it’s not easy to understand.



I will read up tomorrow. I want to be as knowledgeable as I can when speaking with the vet. I want to be able to explain what changes and why I want the changes. She’s been our vet for almost 8 years and hope she will listen.

Thank you for explaining them. Sometimes the info on threads is too much at once. It helps when I have a general idea about what I’m reading before I dive down the forum rabbit hole.

Hexie has been on low carb canned food since diagnosis and we weaned her off dry completely within first month.

Should I leave her dose at the 4.75 in the morning or should I changed it since I never should have gone down the last .25? I know with experience and all of your guys help I will get it eventually it’s just a bit daunting.
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Charia I'm no expert on giving dosing advice , but I would stay with the 4.75 units for tomorrow morning. I will tag Suzanne for you but she's probably sleeping right now
Just be sure to get some tests in . You know if she drops under 90 you need to reduce by 0.25 units
Do you think you can get one more test in soon to see where she's at
@Suzanne & Darcy
@Charia & Hexie
 
Diane Tyler's Mom said:
Charia I'm no expert on giving dosing advice , but I would stay with the 4.75 units for tomorrow morning. I will tag Suzanne for you but she's probably sleeping right now
Just be sure to get some tests in . You know if she drops under 90 you need to reduce by 0.25 units
Do you think you can get one more test in soon to see where she's at
@Suzanne & Darcy
@Charia & Hexie
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Given the numbers that I see on the spreadsheet through the evening cycle of August 27, yes, continue with the 4.75 units (since kitty never dropped under 90.) Now if you have an unexpectedly low preshot number or anything that gives you concern, please post for help.
 
Good morning. I didn’t get another test last night but her AMPS was 210. I will continue the 4.75 units today.

Unfortunately I will not be home for most of the day/evening, which doesn’t happen very often. I only go to doctors and runs errands. I see my best friend maybe once a month, twice if I’m lucky, sometimes not for months on end. And today is that day and mentally really need to get out of the house. Lol. So I will only be able to get PS and bedtimes readings, maybe a +1 before I go.
 
Charia & Hexie said:
Good morning. I didn’t get another test last night but her AMPS was 210. I will continue the 4.75 units today.

Unfortunately I will not be home for most of the day/evening, which doesn’t happen very often. I only go to doctors and runs errands. I see my best friend maybe once a month, twice if I’m lucky, sometimes not for months on end. And today is that day and mentally really need to get out of the house. Lol. So I will only be able to get PS and bedtimes readings, maybe a +1 before I go.
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And will she have food out to eat on while you are away? She needs it.
 
I left a message for my vet. I also have an email ready to go on why I want to change to Glargine and have provided the AAHA info links as well as some others. If she says no I will look for another vet and/or order from Canada.

I am taking a bunch of spot checks today. Will be doing another here shortly.
 
Vet agreed to switch to Glargine, mentioned she has “a” patient that uses it. She wants to start the dose all over. I sent the AAHA info to her and she is going to use it to figure her starting dose and look at the dosing method. She seemed more open and comfortable with the info coming from AAHA. And their methods/info is better than the vets. I haven’t mentioned the human meter, this forum or changing diet yet. I will ease the vet into those or just do it per the forum’s instructions.

Looks like Hexie is due for another decrease this evening. Her +4 & +5 were both 64. She ate a lil in between. No signs of Hypo.
 
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