Daphne's New Spreadsheet Dosing Advice?

Status
Not open for further replies.
Daphne#5 GA

Daphne#5 GA

Very Active Member
Hi,
In case you haven't seen me on this board, its because I've been trying to get this spreadsheet up and running. I know there is a lot to learn yet, but I think Daphne is on her way to being regulated. I also apologize if I don't know all the Lantus Board etiquette yet, but I'm doing the best I can with the time I have and the care I'm providing to Daphne. Of course she is under a Vet's. care, but the "real world board" here, I see can be a life saver or at least a little peace of mind for the kitty mom's and dad's. So this is Daphne's numbers. I have a few questions also, if I could ask? One big one is, HOW do I keep her regular/accurate numbers, while still being able to give her the snack meal each day (I give her 2 meals a day of wet food DM, 1/2 can at each, and then 1/4 can in between those times)? The other question is about the TEST time. Its hard for my husband to test her in the AM and I have opposite hours of sleep, so I'm going to bed about 2 or 3 AM. So, to get the most accurate numbers, can I test at the other end of 12 hours? That would be about 5:30 PM, instead of the morning one at 5:30 AM?
Thanks in advance for any help on the dosing, and thanks again Sue, for helping me with the spreadsheet.
Barb and Daphne
 
Hi Daphne and Barb.
Good job on getting the spreadsheet up :razz:

It is best to test before every shot, so you know what the blood sugar level is before giving insulin. You wouldn't give your child insulin without knowing her blood sugar level first. We advise testing before every shot.

Also, get as many mid cycle tests (around the time of nadir, usually +6) as you are able to. That way, you can tell how the insulin is doing. If the nadir is really low, you may need to decrease the insulin. If the nadirs are consistantly high, then you probably need to increase the insulin.
I'm sure you've already been told this, but read and re-read the Stickys in the Lantus forum, when you have a chance.

When I'm home, I try to feed three mini meals of about 1/4 can of Fancy Feast each in the morning (at AMPS, +3 and +6) and I try to feed three mini meals of about 1/4 can of Fancy Feast each at night (at PMPS, +3, and +6). I don't always :roll: stick to this schedule, but smaller portions in more meals is usually better. The quantity is ECID (Every Cat Is Different). I fed cans of Purina DM in the beginning. My cat actually liked it, and he ate a whole case of it. Then I found out that the ingredients aren't that great, and some of the low carb commercial brands like Fancy Feast, Friskies, 9 Lives, etc., are actually better.

That's all for now. Good luck with Daphne. Give her some extra skritches from me.
Hope you have a good day :-D
 
I'm not familiar with Lantus as my Harry was on Prozinc but it looks like you might need to lower Daphne's dose. The 117 is a normal number and wouldn't require any insulin. I can only tell you what I did but as I said Lantus works differnt than Prozinc - when Harry was around or just under 200 I gave him a very small dose and if he was under 175 I didn't give him any at all. I think you should asking for dosing advice in the Lantus forum as everyone there using that kind...
I know you are doing the best you can (and you are doing great!!) but if you could figure out a way to test her before her shots (and make sure she hasn't eaten in the last 2hrs) and at +6, the reason I would suggest this is because the last couple numbers you got are in the normal range and it could be dangerous to give insulin at those numbers... the normal routine is test, eat, shoot (if the numbers warrant it)
As far as feeding goes for Harry I test him and then give 1/2can of Friskies (so about 2.75oz) he is currently on day 9 of no insulin but when he was getting it I would let him eat some then give the shot. At about +6 I would test again and then he gets 1/2 can of fancy feast (so about 1.5oz). Then the same thing for the night time. And of course he gets low carb treats every time we test.
I'm sure someone with more experience will give their input also but like I said you may want to post in Lantus to get some ideas on the dosage for Daphne. Good Luck!!!

Sharon
 
Thanks for the advice. I'm working on my husband to test her in the AM. I understand that it could be dangerous now, especially that we got her numbers down finally. The lowest we ever got was 78, about 4 days ago. I actually posted here by mistake, and so I reposted it on the Lantus board after I figured out what I did. So I'll add one more number to her spreadsheet today, and I will test her at 6+, since I see that it is also an important test time. Oh, and that answers a question…I was wondering how long the numbers spike after food, so it looks like about 2 hours, so now I'll know when I give her a snack, I will know why her numbers are high for that time period.
Thanks again for all the advice!
Barb p.s. Dyana, I'm about 15-20 min. away from you, I'm in Hopewell.
 
Daphne#5 said:
Barb p.s. Dyana, I'm about 15-20 min. away from you, I'm in Hopewell.
Click to expand...
Cool. Nice to meet you, neighbor :-D I think you're the closest FDMB person to me. You ever need help, just let me know.
 
Lantus is definitely adjusted based on the nadir and the nadir is usually sometime between +5 to +7. Any spot checks you can get in there will help.

Also, for safety, without a lot of data, we generally recommend no shots below a glucose of 200.
With lots of data, no shots below 150 (some cats shoot lower, but they have LOTS of glucose tests showing how they respond to the insulin).

Since this means there are some times you could have skipped, a dose reduction of 0.25 - 0.5 is not unreasonable.
 
Same here Dyana!

Thanks for that info. BJM. I just got a low number now, and it worried me, so I gave her a 1/4 can of food. I'll make sure my husband will test her for the AMPS. It was 83 at the +6 just now, so I can tell him to only give her maybe 2 u and then we can call the Vet to see what she thinks. It looks like you have your hands full with high numbers, thats what Daphne had at first, her back legs weren't working very well. They are getting stronger now. I'm so exhausted from all of this. My first cat with diabetes was on 1u and it was never adjusted, and she lived till she was 17. This is all so different with Daphne.

Thanks again for the ideas!
Barb and Daphne
 
hi barb!

my first question is to ask what your goal is? are you hoping to get daphne off of insulin or are you wanting to find a dose to just maintain her as you did your first cat? it makes a difference in the tactics that you take.

if you want to get her off of insulin, she looks to me like she would be a good candidate. the reason i say that is because you are seeing healing numbers (everything less than 120ish) and not too much bouncing to really high numbers. The protocol that many people on the Tight Regulation forum follow has a great track record for cats going off of insulin entirely if they get on Lantus soon after diagnosis and begin following the protocol. The basic premise of the protocol is that we try to get the cat's BG in normal, non-diabetic cat BG numbers, which is mid-40's to 120ish.

if you want to go that route, i'd encourage you to post in the Lantus Tight Reg forum and we can teach you about it. many of us post daily, some people learn what they need to know about how lantus works and only post occasionally. i've been on since the end of february and have seen at least 30 cats go off of insulin since that time.

also with lantus, dosing decisions are made on the lowest number of each 12 hour cycle. it is at its peak somewhere between +3 and +8 or so - most cats are in the middle, but definitely not all. some of our cats peak at about +3. that's one of the reasons we do more testing at the beginning so we can learn what our own cat's pattern is and how it responds to the insulin.

lantus also likes consistency. same carbs in foods (i feed the same food), same timing, same doses - and every change means that you'll want to hold that new change for a few days to see how it settles in.

a couple of comments about your routine - with lantus it's best to keep most of the food in the time between giving the shot and about 4 hours later. the reason is that you have the lantus working when the most carbs are in the system. most of us avoid giving much food between +6 and the next shot, although every cat is different and some people have discovered their cat does better with a little snack in there. I found punkin's numbers improved dramatically when i moved his food plan to 1 can of low carb fancy feast with the shot and 1/2 can 3 hours later. he weighs about 13.5 lbs.

usually after +6 the lantus is wearing off and beginning a gentle rise in numbers until the next shot time. 83 is a very safe number - really ideal, in fact. nothing wrong with what you did, i'm not saying that, just saying you didn't need to worry about it.

good job with all you've accomplished so far! it's a whole new world for most of us!!! scritches to daphne! cat_pet_icon
 
Hi Julie and Punkin,
Thanks for all of your advice. The answer to the first question is yes, but I would think that everyone would want to get their kitty off the insulin. So I'm a bit confused, but maybe its because, if she is off the insulin, she will need to live a very restricted life? I don't think it would be such a bad life, she likes the food, the only thing that would be hard, I think, would be to not eat as much as she would like. She was a little over weight when diagnosed, but once on the caned Purina DM, and we stopped the free feeding, she lost it fast. Funny thing, I had the hard food DM for my other cat that had diabetes and since I had 4 cats at that time, I had them all on it,… didn't know how else to do it. So Daphne has been on DM for most of here life, she's about 16 or 17 now, we adopted her when she was about 5 years old.
I can only assume getting off the insulin when the cat has pretty good numbers like she has now, that I will have to watch for signs of diabetes coming back, and/or test? I have to admit, its hard to say no to her, when she wants a snack (and yes, her snacks are all the same food). The other problem was she had such a hard time getting the whole 1/2 can down at once, thats why I started with the lesser amount at both feedings and give her the 1/4 cans in between.
And now for the idea of going on the Tight Regulation Forum, I'm not sure if I can do it. I have an illness that interferes with sleep and I have a lot of pain, so I need to put my health first sometimes, (trust me, it's not often), I was up all night last night, just to make sure she was ok. (thanks for letting me know that 83 wasn't bad)… So maybe I will just read the post on that forum first to see if I could keep up.
For now then, I will try and put her on the schedule you advised, "food between shot and 4 hours later, and no food after the +6 and next shot". I'll see if Miss Daphne will put up with this, and let you know and maybe work up the courage to go onto the Tight Reg. forum.
Thanks for your help…advice is always appreciated!
Barb and Daphne
 
just to encourage you a bit - the Tight Regulation name scares people, i think, but it's named that because of the protocol we follow. you can choose what you do, but the protocol teaches how lantus works, the amount you should adjust a dose by, when to increase, decrease or hold.

basically it's a recipe "if you see numbers like this, do this." i've been doing this with punkin since february, and in that time i suppose i've had to wake up during the night just to check him maybe 7 or 10 times, and not at all for quite a while. so it's averaged out to perhaps once a month. when i do have to check him during the night, i set a cell phone alarm, test him, feed him if necessary and go back to sleep. wake up again if i need to or maybe sleep the rest of the night.

there's no one that stays up all night every night to test our cats. we mere mortals need our sleep for all the things that we do during the day, like go to jobs or take care of children or our parents! :lol:
 
Thanks for the info. I may have to wait till after the holidays, I'm running on empty these days. But Daphne is doing very well with her numbers, its just her legs that aren't great, and I do have to buy that Vit. B12, and she is 17, so I'm not sure what I should really expect.
Thanks again,
Barb and Daphne
 
Status
Not open for further replies.
Back
Top