Davidson - Jan 19th update

[Shawna & Davidson (GA)]

I saw another post in the general Forum and they suggested that post be moved here since her kittie was on Lantus........so is Davidson so thought I'd post here for your thoughts in case this is where I'm supposed to post.

Davidson started Lantus Jan 15 on 1.5u and was dropping nicely day 1, I messed up at the PMS and reduced his dose to 1u, been doing 1u twice daily since with numerous BG's and he's still averaging in the 300's. He's building his depot, he's wonki, and I'm keeping him on the 1u until Monday. Todays +10 was an hour after feeding so high. I'm up to date with his SS and your feedback is appreciated.

QUESTION - what's the difference where we post our topics as most of the people on here who post comments and read both? I'm learning.........

I'll be speaking with my Vet Monday as he wanted a follow up over the weekend and would like to give him YOUR comments as I always have..........which he supports.

We're getting there.........slowly!!

Shawna

 

[Cleo & Jane (GA)]

Hi and welcome to you and Gecko

In the Lantus TR forum, we usually start a new post (condo) each day, with the date, kitty's name, AMPS (morning pre shot #), then add bg numbers, as +1, +2, etc. If you have a question you need answered, click the ? radio button, and add something like, "dosing ??"

When you have the time, there are "stickys" at the top of the Lantus Tight Regulation page. They offer great information, and will probably have a lot of the answers you are looking for.

Have a great Sunday, Shawna

 

[Wendy&Tiggy(GA)]

hey there

i was looking at his SS and am thinking its time to increase to 1.5 because he is pretty flat and pink . This will take you back to the starting dose we recommended and I believe where your vet wants you

FYI the protocol says

"General" Guidelines:
Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).
Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).
Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.

Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.

PS Everyone here is her post on health: http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=111409 and http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=112049

 

[Sienne and Gabby (GA)]

To answer your question about where to post, the Health board is where we encourage everyone to start. The process of managing your kitty's diabetes is, at the very least, overwhelming. On Health, you'll get a great deal of guidance about the basics -- what to feed, setting up a spreadsheet, and most importantly, home testing. Once you've mastered the basics, many people want more specific guidance with respect to the specific insulin their using. Some of the people who post on the Lantus board also spend some time visiting on Health. There are some of us who spend the bulk of our time helping people with their Lantus questions and spend very little time on Health unless we're asked to stop by to help with a specific situation. In other words, there are more people with a general knowledge of Lantus on Health vs. here, where there is more specific knowledge.

If you started using Lantus on 1/15, you usually want to give Lantus 5 days for the depot to stabilize unless Davidson has been experiencing ketones. I do think it was OK to increase today, however.

I want to strongly encourage you to read the starred, sticky notes at the top of this board. They will provide you with a great deal of information about the dosing protocol we use so you can make good decisions about when and how much to increase Davidson's dose. Of course, we are happy to help you with those decisions especially at this early stage in learning about how to use Lantus.

Please let us know if you have questions.

 

[Shawna & Davidson (GA)]

Increased, thanks..........thought so as he was pretty flat for the past 3 days.......will update SS accordingly and monitor today and do a BG at +5

 

[Ella & Rusty & Stu(GA)]

Welcome to Lantus Land, Shawna and Davidson!
As Sienne suggests, a good reading of the "Stickies" at the top of the Lantus Forum will provide you with lots (LOTS) of information! It can be overwhelming, but it gets sorted out eventually. Good luck with your dose increase.

Ella & Rusty

 

[Shawna & Davidson (GA)]

Thanks..........I now have a more in depth knowledge of which Board to post on.........Appreciate ALL your help thus far and soon I'll be so well versed I can get my MBA in Feline Daibetes :mrgreen: :mrgreen:

 

[julie & punkin (ga)]

Hi Shawna,

Yes, you'll have a graduate degree in feline diabetes before long! You'll be amazed - by 2 weeks you'll know a ton more than you do now. i'm still learning and i've been doing this for 3 years now, but there are still little tweaks in cat-specific situations that come up.

you're doing a great job. i'm glad you increased this morning. Davidson is pretty high. I refer back to the Tight Regulation protocol all the time to re-read the nuances. I've bolded the parts below that apply to your situation.

"General" Guidelines:
Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise.

Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).

Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).
Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.

Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.

After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.

So right now, Davidson is in the increasing phase of the protocol. With nadirs over 300, you want to increase his dose by 0.5u every 6 cycles. Keep doing that until you see nadirs that fall under 300. Then we look to see what the nadirs are and adjust the speed and size of the dose increases.

It's also going to be helpful if you can get a test in the first half of the pm cycle - a +2 or +3 will tell you where he's going for that cycle. Many cats go lower at night, and I know Davidson hasn't yet, but he likely well. Doing an early test helps you know if he needs more monitoring in the next few hours.

I'm not sure what you meant when you said:

Todays +10 was an hour after feeding so high. I'm up to date with his SS and your feedback is appreciated.

Did you mean feeding? Most people don't feed after +4 or so. Feeding later in the cycle when the lantus is waning can drive up the numbers.

Does that make sense?

eta - i just saw Wendy/Tiggy posted all of that. hahahaha. oh well, let's just re-emphasize it! and Main Health is the place to start, but here is the place to get daily monitoring and learn all the fine points. plus it's a great support group! feel free to read other people's posts. it's a great way to learn.