Change her dosage?

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Heather and Raja (GA)

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Raja has been on lantus for 4 days now at 1 unit and her numbers are still pretty high save for last night so should I wait a full week before changing her dose or should I up it starting tomorrow and if so by how much?

I believe I set her chart up right in my signature
 
Welcome back!

To cut the the chase, no, that 78 definately resets the clock on any dose increase. You are probably bouncing off of that low reading and the missed shot. It can take 72 hours for the effects of a low number to wear off, and you don't know how low he may have gotten yesterday. Given how quickly he responded to 1u, I don't know if you will need an increase. You may already need to decrease after the numbers settle down.

I know you were just on insulin for 1 month back in '08, but did you follow a tight regulation protocol back then, or is this your first time? The current "official" sticky for TR with Lantus or Levemir is STICKY: LANTUS & LEVEMIR - TIGHT REGULATION PROTOCOL

If you want more experienced help with dosing Lantus, you should probably post over in the Lantus forum.

It looks like you still have the testing technique down!
 
No I wasn't on a tight protocol the first time

I went to a bad vet who gave me U40 insulin needles instead of U100 and it took me about a month to realize that so I was overdosing my poor baby big time. That just messed everything up.
 
We're all learning. :? :? :?

You should definately spend some time reading the Stickies in the Lantus forum. If you look down in my signature, the quick start guide has most of the ones I go back to linked in.

If you could read through the rest and make sure that you are up to speed elsewhere as well, I would not want to miss something. For example, what food are you on? Do you have your Hypo kit put together?

I'm signing off for tonight, but I'll check in tomorrow, and I'm sure others will come by to say hi.
 
Last thought. Those are high numbers in this bounce. Do you have Ketone urine test strips to make sure that Raja is not going ketotic? If you can, you'll want to test once a day so long as you stay this high.
 
To get urine...try putting the litterbox in the bathroom or somewhere you can close the door for a few hours. Makes it easier for me to test my cat.
 
There is a great deal of helpful information on the Lantus board with regard to dose, how to handle your insulin, managing low numbers, etc. Below is an overview:
  • Tight Regulation Protocol: This sticky contains the dosing protocol that we use here. There are also links to the more formal versions -- the Tilly Protocol developed by the counterpart of this group in Germany and the Queensland/Rand protocol developed by Jacqui Rand, DVM and published in one of the top vet journals.
  • New to the Group: Everything you wanted to know about this forum and more. Info on our slang, FAQs, links to sites on feline nutrition and to food charts containing carb counts, how to do a curve and the components to look for, important aspects of diabetes such as ketones, DKA, and neuropathy, and most important, info on hypoglycemia.
  • Handling Lantus: how to get the maximum use from your insulin and what to not do with it!
  • Lantus depot/shed: This is an important concept for understanding how Lantus works.
  • Lantus & Levemir: Shooting & Handling Low Numbers: What data you need in order to be able to work toward remission or tight regulation as well as information if you have a low pre-shot number or a drop into low numbers during the cycle.
 
Thanks for coming by Sienne!

It's nice to see Raja stay in the yellows for you. She's trying hard! Make sure you get some readings during the day today if at all possible. Since she was down at 78 at +12 on Thursday (she was likely much lower earlier on Thursday), there is a good chance that she is going to go to some very low numbers in the middle of the day one of these days (or in the middle of the night). Hopefully she gives you nice "comfortable" numbers in the 80's, but it is also possible that her pancreas with start up with a vengence one of these days, and she can get down in to the dangerous numbers <50. You want to get measurements on the +2's and +3's to see how quickly she is dropping, and you want to make sure you are ready to deal with a fast drop to low numbers.

Do you have your hypo kit stocked up? Symptom list, treatment instructions, Corn syrup, high carb (gravy) food, extra test strips, etc?
 
I was checking in on you, and it looks like Raja spiked back up again! This is where your patience will get tested. Lots of cats bounce up and down and up and down until the finally settle down in the right range. That is why the protocol requires at least 6 cycles CONSECUTIVELY of high readings before you make an adjustment up. Some people here have taken that one step further to say that the 6 cycles don't start until any obvious "bounce" clears.

This is actually the "fast" version of the protocol, and going faster will probably cause more problems than it helps. The older "start low, go slow" protocol required even more patience.

Do a search for "patience pants" and you'll find good company.

Early on, when S'mores bounced around some, I kept refering back to this figure from the Roomp/Rand paper where the cat bounced high and low until finallly settling down at the low end, with very little change to the dosing.
 

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Thanks for info, I did read everything but I didn't join the lantus board 3yrs ago and it's a little overwhelming even though I joined 3yrs ago.

I don't mind being patient with her, and I will say she is getting better weight wise. She started at 9.6lbs and she stayed that weight for 3yrs but then she got sick and she got down to 8.15oz last Saturday. I could tell she gained some weight so I took her back today just to check her weight and she's up to 9lbs! I do think though that they didn't weigh her right to begin with because she feels heavier and I just don't think I'd be able to tell that big of a difference for an oz. I could feel her backbone and her tail was nothing but skin and bones and her stomach was 'caved in'. Her tail looks almost normal now and her stomach isn't as caved in and even her back bone doesn't feel as boney as it was just a few days ago.
 
I had a similar experience with S'mores when he came back from the vet ER first. He seemed to fill out almost immediately, but the scale SWORE that he had only gained a couple ounces. I'm glad he seems better!

I also love that he's come right down off of the 511!

As a very minor note, could you change your SS link to this link? It is the HTML version, and it loads much quicker (expecially on my iphone).

Code: 
https://docs.google.com/spreadsheet/ccc?key=0Ajep1eXAmHAVdFBLUEoxQkR5ODhqR1dOa2RaWVpYSGc&output=html
 
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