Chaz bg readings - request dosage advice

Kelly & Chaz

Kelly & Chaz

Member Since 2019
Hi all. My Chaz has been on lantus since early December. We started low (.5 unit), as he seems to be pretty insulin sensitive (based on previous short stint on vetsulin) and he has had some fairly good nadir #s since. He seems to spike overnight though, all of his 300+ numbers occurring at the amps. His last feeding is usually around 10-1030 pm. Then sometimes he’s borderline low still at pmps, leaving me wondering what to do. I’ve skipped a couple, and reduced a couple. Now that we have some numbers to track, would you mind taking a look at his SS and advise on dosage?? Almost all of his numbers on SS are at least two hours after eating. He’s on all canned fancy feast pate, 4-5 feedings per day (1/2 can each time). He is eating well, regular litter box habits as far as I can tell, seems well overall.
 
Welcome Kelly!

A few questions if I may... When you started Lantus, did the vet mention you needed U100 syringes vs the U40 syringes you use with Vetsulin? Also, one very big difference between Vetsulin and Lantus is that Lantus dosing is based on the nadir, not on the pre-shot number.

Have you had a chance to look over the sticky notes? In particular, have you reviewed the note on the two dosing methods we use? You will want to decide whether you're going to follow Tight Regulation (TR) or Start Low Go Slow (SLGS). Choosing a method will help you with dosing decisions.

If you're feeding Chaz his last meal at around 10:00, when it that in relation to shot time? (At what +time is the 10:00 meal?)

In terms of Chaz's spreadsheet, I'd encourage you to get a "before bed" test every night. Many cats experience lower numbers at night and you want to make sure your kitty is in safe numbers before you go to sleep. in addition, if you don't get tests at night, you're missing half of your data.

I think it's possible that Chaz's numbers may have dropped a bit lower during the PM cycles preceding those AMPS numbers in the 300s. Chaz may have bounced high in response to a lower number than he's used to.

I think you're OK to keep the dose at 0.75u. Given that you've seen some green numbers at nadir, you may want to get some tests at around +3 to let you know where numbers are heading.
 
Hi, yes I am using the u100 needles. We are using the SLGS method for Chaz, as we never had a bg higher than 300s recorded. His last meal of the day would be pm shot +4 to +5. I have been trying to get readings mid am cycle (am shot +6 or +7) when it typically should be the nadir I understand? Then, some of his nadirs have been at pmps, leaving me in a quandary for shoot/no shoot pm.
Also, the .75 dosage this am is the first increase we have done since starting insulin a few weeks ago. I have been afraid to increase based on the recorded nadirs.
 
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A cat’s nadir can and do change. For example, nadirs are generally later when bounces are breaking. I used to joke that Neko’s nadirs were reliably between +3.5 and +13 when she was on Lantus. Though more often between +7 and +9. Typical Lantus nadir is around +6, but it’s your job to figure out when Chaz’s onset and nadir are. That means doing some curves as per SLGS, and sprinkling some random spot checks around the spreadsheet. Looks for spots with lots of white space, and fill them in. I see a lot of white space in the early hours of the cycle, you will need some more +2 and +3 to spot the onset.
 
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