Calling all Dosing Experts!

[Smokey]

Hello Ladies! It's me again :cry:

I am so confused about something and was wondering if you could help me! Actually, I know you can help me!

Since Smokey's low BG 2 nights ago, It has been suggested that since he has been having some blue's and green's that I decrease his dose to 1.75. I guess I just don't understand, from everything I am reading and looking at other SS's, I thought that my numbers were bad and called for an increase in Insulin...?

Isn't Smokey around the Renal Threshold atleast once a day? It was my understanding that I should be striving for a dose that gives greens and blues so maybe I should be striving for higher numbers? What range do I want to see at Pre-Shot?

If his lowest BG is usually around Pre-Shot, how will I tell when or how much to shoot? Normally, that would be the cats highest BG (therefore, you'd be basing the dosage on that number).

Since his Dx (he was previously OTJ), he has never stopped drinking the water and urinating clumps the size of dinner plates (which also led me to believe he wasn't getting enough insulin). I just haven't seen any positive things...clinically.

My vet was the one who kept telling me that a Lantus pre-shot should be between 300-350 and I was preparred to tell him [this Thursday] that I thought he was crazy and I really would like to increase the dosage. Now, if I lower the insulin dosage, his pre-shot numbers will be up in that range.

I hope I'm making sense, sometimes it's hard when reading an e-mail!!

Thank you all again so much!
xo

 

[Beth & Atlas]

First Lantus is not based on pre-shots, but on nadirs. Not all cats have the predicted nadir at +6ish. A good SS to look at is my very own Atlas's. He is notorious for a late nadir and because of such, I've had to gather lots and lots of data and own several BOS sets awarded by Lantus Land for shooting low.

Looking at your SS I see you dropped below a 50 on 4/17 late in the cycle. That would normally call for a dose reduction of 0.25u. The high numbers you are seeing today and likely for the next 72 hours is what we call "the dreaded bounce."

The bounce is the liver reacting to suddenly normal numbers by releasing hormones to counteract the lower BGs. This normally will clear in 72 hours and as a new Lantus user it is highly encouraged that you follow that protocol at this time.

Upping the dose, when not allowing the body to adjust, can result in a missed correct dose amount. This situation can lead to a prolonged hypo event. You really don't want to go there. With Lantus building a shed or reservoir of insulin it could be a 12-24 hour event or longer.

So...new to Lantus + below a 50 reading=0.25 reduction and allowing 72 hours to re-stabilize.

 

[Smokey]

Thanks, I notice on your SS that when Blue is very low 40-60 you still shoot his normal dosage?

 

[julie & punkin (ga)]

denne, you want to have lots of info on your cat before you do that - a well-filled out spreadsheet and lots of experience!

 

[Beth & Atlas]

Thanks, I notice on your SS that when Blue is very low 40-60 you still shoot his normal dosage?

A good SS to look at is my very own Atlas's. He is notorious for a late nadir and because of such, I've had to gather lots and lots of data and own several BOS sets awarded by Lantus Land for shooting low.

Yep...I call it shooting for the overlap and that is only done when you have lots and lots of data. It is the last option in "Dealing with Low Preshots" series of choices.

In your case ...you're not there yet.

As my post indicated for your set of circumstances you should be taking that decrease in dose. New users who go below 50 take the reduction for the reasons I discussed.

 

[Smokey]

Thank you...

I am taking Smokey to the vet tomorrow for another T-4 test. His initial T-4 that diagnosed the return of his diabetes was 4.3 (which Doc. said was in the grey area). His behavior just isn't matching his numbers so I know in my heart that something else is wrong.

 

[robert & spade]

hello there........isn t this fun not... at times you will pull your hair out....times you will be under control......2 things id like to mention...... # 1 your cat has a reserve if he or she has been drinking aot... im sorta thinking the reserve is low. if the reserve gets full....what your give the cat could be to much insulin...# 2 there is a over lap between shots...lantis is long lasting, for me i home test i make a point of testing my cat 4 hours after his shot, for my cat his over lap was 3 to 4 hours..... that you have to watch to low over lap could be a problem...... i don t know if ive helped...... every thing ive said is from my cat how he and i have learned over the years.. you have to know how your cat reacts to the shots,,,,signs of low and high.... and really home testing is best... you get better results..minimal stress. a stressed cats results are not always true..... hope ive helped.... you love you cat thats why your here,,,me also

 

[linda and guinness]

I would trust your gut. My vet said that 2.5 was the high end of normal for his age (12 years old). Eventually, you might find a huge division between the advice you are getting here and your vet's advice (the biggest cause of my stress in the past). I finally had to decide to go with one (which ended up being here) and found that it was the best decision I made, but every cat is different and every bean is different so you will have to make the decision on your own.

Good luck tomorrow. We are back to the vet on Wednesday for a dental follow up and discussion about when to test for t4 and free t4 again.

 

[Marje and Gracie]

I'm not a dosing expert but Smokey's SS doesn't look all that different from many in LL. I think Beth was right on with is going on and if you are following protocol, he earned a reduction; you can't "bank" the reductions...you need to take them as you earn them. Hope you shot 1.75u tonight.