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Dosing advice please
- Thread starter Sue484
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Chris/China (GA)/Garfield
Member Since 2013
Hi Sue...Sorry that nobody got back with you before shooting, but looks like you handled it!
In the future, you have a few options when shooting a lower number...You can Stall, don't feed, and test every 20 minutes or so and then as long as the numbers are going up, you can be pretty sure that the last shot is wearing off and it's OK to go ahead with the scheduled dose. Remember, when you shoot, you're also going to be feeding, and Lantus doesn't fully "kick in" until around +3, so as long as the numbers are going up, it's usually fine to go ahead and shoot
It'll be important that you get comfortable shooting lower and lower numbers too....that's when Lantus works best! Once we have enough data on how our cats respond to insulin and food, most of us will shoot anything above 50 (that's90 120 for you since you're still feeding some dry so have to stick to the SLGS protocol instead of the Tight Regulation protocol---And using the AlphaTrak meter)
You can also do what you did and shoot a reduced dose....but if you find you're getting pre-shots too low to shoot, it's usually because the dose is too high to begin with. Lantus needs to be given at the same dose to work it's best, so every time you change dose, it throws it off
Another thought I have is that you may have increased too quickly....We usually only increase in .25 unit increments and it looks like you've gone up in whole units each time you've increased. One of the peculiar things about insulin is that too much can look like too little! It's important to go up slowly so you don't go past what might be a "best dose" for your cat.
I have to think that it's possible Frankie was started out at too high a dose to begin with. It's my understanding that he was started at 3 units? Is that correct?
Are you going to transition him onto low carb canned and get rid of the dry? Getting the high carb dry totally out of the picture will help in getting him under better control a lot easier
In the future, you have a few options when shooting a lower number...You can Stall, don't feed, and test every 20 minutes or so and then as long as the numbers are going up, you can be pretty sure that the last shot is wearing off and it's OK to go ahead with the scheduled dose. Remember, when you shoot, you're also going to be feeding, and Lantus doesn't fully "kick in" until around +3, so as long as the numbers are going up, it's usually fine to go ahead and shoot
It'll be important that you get comfortable shooting lower and lower numbers too....that's when Lantus works best! Once we have enough data on how our cats respond to insulin and food, most of us will shoot anything above 50 (that's
You can also do what you did and shoot a reduced dose....but if you find you're getting pre-shots too low to shoot, it's usually because the dose is too high to begin with. Lantus needs to be given at the same dose to work it's best, so every time you change dose, it throws it off
Another thought I have is that you may have increased too quickly....We usually only increase in .25 unit increments and it looks like you've gone up in whole units each time you've increased. One of the peculiar things about insulin is that too much can look like too little! It's important to go up slowly so you don't go past what might be a "best dose" for your cat.
I have to think that it's possible Frankie was started out at too high a dose to begin with. It's my understanding that he was started at 3 units? Is that correct?
Are you going to transition him onto low carb canned and get rid of the dry? Getting the high carb dry totally out of the picture will help in getting him under better control a lot easier
julie & punkin (ga)
Member Since 2011
What insulin was Frankie on before he was switched to Lantus? Can you tell us a little about that story, and if you have any dose or blood sugar test info from the year before you started on Lantus that would be helpful to put into your spreadsheet?
And welcome! Since you've already been doing this for a while you might not have as many questions as some people, but feel free to ask whatever you're wondering about.
And welcome! Since you've already been doing this for a while you might not have as many questions as some people, but feel free to ask whatever you're wondering about.
Sue484
Member Since 2015
Frankie was on Caninsulin for a year before switching. He started off at .5 of a unit twice a day and was increased by .5 each time until he reached 8 units twice a day. His nadir very rarely went below 20 (360). I have started seeing much better numbers on this dose of Lantus and the low reading yesterday I suspect was because I have now stopped all dry food. Trouble is, he's an addict, so I need to find a substitute. I am doing a curve today and from tonight will be transitioning him to low carb food. It was the RVC who told me to start at 3 units because of his bad neuropathy. They said they need to get it under control quickly as he is getting worse very quickly, even on Zobaline. This is the lowest he has ever gone, so seeing numbers that low, even though I have been doing this so long is scary.
Sue484
Member Since 2015
This is the third time where I have questioned myself on the amount to shoot. I know that it is safe to shoot the full dose with him as I have done it once before but he was on dry food too then so, that's why I was unsure. So what is the cut off point in when to shoot? I presume 50/18 which is 2.7. Really? That seems awfully low and below the normal range for a healthy cat.
Sue484
Member Since 2015
I need to retrain my brain that this does not work like Caninsulin and therefore should not be treated the same. Harder than it sounds when you have been using one type of insulin for a year and know exactly how it works and have another cat regulated well on it. Still, it's only been a month. I need to believe in myself more. I knew I was doing wrong giving him half a dose but I just didn't have the courage to believe it.
julie & punkin (ga)
Member Since 2011
Yeah, i've seen a lot of people struggle with making the mind-shift in how the dosing works. I've only used Lantus but can imagine it would be tough to make the change. With Lantus the mid-cycle tests become more important because your dosing is based upon how low the dose takes the cat - which typically happens somewhere in between the shots, not at preshot.
One suggestion - even though you've got "Alphatrak" in your signature line, it's really easy for people to miss it. You don't want people to think he's higher than he really is. It can be really helpful when people put it in the subject line with the BG#s - because AT's are equivalent to lower numbers on the human glucometers which is what most people use. Frankie's 150 the other day is probably around 30-40% less - so that test would've probably been green on the spreadsheet with a human glucometer. That's great - think of it as progress!
As you're changing from dry to canned low carb, he'll need less insulin - you can let the tests guide you on that. Or post and we can help you look at it and figure out what to do.
It was ok to reduce the dose when you had a lower preshot. You'll work up to feeling comfortable shooting lower numbers, but you need enough info on the mid-cycles to be able to do that.
One suggestion - even though you've got "Alphatrak" in your signature line, it's really easy for people to miss it. You don't want people to think he's higher than he really is. It can be really helpful when people put it in the subject line with the BG#s - because AT's are equivalent to lower numbers on the human glucometers which is what most people use. Frankie's 150 the other day is probably around 30-40% less - so that test would've probably been green on the spreadsheet with a human glucometer. That's great - think of it as progress!
As you're changing from dry to canned low carb, he'll need less insulin - you can let the tests guide you on that. Or post and we can help you look at it and figure out what to do.
It was ok to reduce the dose when you had a lower preshot. You'll work up to feeling comfortable shooting lower numbers, but you need enough info on the mid-cycles to be able to do that.
Hello and welcome from me too. My Neko was on Caninsulin for a couple of months before switching to Lantus. She got up to 5U of Caninsulin. Strangely enough, my vet figured out what was the right dose by the low point on Caninsulin, so it was pretty easy for me to make the transition to Lantus dosing.
On this forum, we suggest that the first time you see a preshot below 150 (8.4), you do not feed, and post for help. If someone is around, they can help you through the options.
On this forum, we suggest that the first time you see a preshot below 150 (8.4), you do not feed, and post for help. If someone is around, they can help you through the options.
Sorry about that. Some times during the day are quieter than others.
purrdydolly
Member Since 2014
If you're using an alphatrack the 50/2.7 absolute cut off becomes 68 I think, which is a normal number in a non-diabetic cat.
Elizabeth and Bertie
Member Since 2010
Hi Sue, saw you were online so just popped over from Health forum to wave 'Hi'.
Well done for dealing with that low preshot.
You're doing just fine.
Reassuring hugs,
Eliz
Well done for dealing with that low preshot.
You're doing just fine.
Reassuring hugs,
Eliz
Elizabeth and Bertie
Member Since 2010
Hi again, Sue,
If you need advice and it's looking quiet on the Lantus forum then do post on the Health forum also. There may not be experienced Lantus users online there but there may still be people who can give general advice (or reassurance) on handling low numbers.
Eliz
Tina & Sammy
Member Since 2010
If you have removed all dry kibble from his diet you will probably want to keep close tabs on Frankie because it is more than likely that you will see lower numbers more often. When I switched Sammy from dry food to a completely wet diet his numbers dropped considerably and he was on a much lower dose of Lantus.
Sue484
Member Since 2015
How long before his numbers started dropping @Tina & Sammy ? I am starting the transition tonight.
Tina & Sammy
Member Since 2010
Check out the TrueResults sheet on Sammy's spreadsheet. I found this site on 1/7/10 and started the transition right away. His numbers changed almost immediately, but if you look at the notes there were times when Sammy got dry food even after we switched him to wet.
We changed to a different meter in January 2010, and then around about 2/3/10, we implemented the mini-meals and he almost immediately went all GREEN.
Sue484
Member Since 2015
@Tina & Sammy what do you mean by mini meals?
Tina & Sammy
Member Since 2010
I feed Sammy small meals every hour or two throughout his cycle. When I first started doing mini meals the first time I fed Sammy 1/6 of a 3 oz can about every hour. We are now using larger cans so I started with about 2 tsp, and then converted to grams. I am still doing mini meals, but Sammy has sort of learned to just eat a little at a time so I could pretty much put out the food and know that he won't eat it all at one time.
Here is a sample of the mini-meal schedule:
Mini Meals
PS - small meal 2 tsp or 15 grams
+1 - small meal 2 tsp or 15 grams
+2 - small meal 2 tsp or 15 grams
+3 - small meal 2 tsp or 15 grams
+4 - small meal 2 tsp or 15 grams
+5 - small meal 2 tsp or 15 grams
+6 - small meal 2 tsp or 15 grams (I sometimes skip this meal depending on if Sammy is hungry)
+9 - small meal 2 tsp or 15 grams (this meal helps keep him satisfied through to the next PS
As I said our schedule has evolved, but at least it is a place to start. You want to make sure that Frankie is getting the right amount of food for his weight. You might need to adjust this based on how much food he gets for his weight. Sammy is 14 pounds so he eats about one and a half 5.5 ounce cans of food a day. Just determine what Frankie needs to eat for his weight and the divide it up into smaller meals. I know some people don't like to do the hourly feeding and do every other hour and just doubling up on the amount. Just start somewhere and then experiment with what works for you and see how Frankie reacts to the food.
Here is a sample of the mini-meal schedule:
Mini Meals
PS - small meal 2 tsp or 15 grams
+1 - small meal 2 tsp or 15 grams
+2 - small meal 2 tsp or 15 grams
+3 - small meal 2 tsp or 15 grams
+4 - small meal 2 tsp or 15 grams
+5 - small meal 2 tsp or 15 grams
+6 - small meal 2 tsp or 15 grams (I sometimes skip this meal depending on if Sammy is hungry)
+9 - small meal 2 tsp or 15 grams (this meal helps keep him satisfied through to the next PS
As I said our schedule has evolved, but at least it is a place to start. You want to make sure that Frankie is getting the right amount of food for his weight. You might need to adjust this based on how much food he gets for his weight. Sammy is 14 pounds so he eats about one and a half 5.5 ounce cans of food a day. Just determine what Frankie needs to eat for his weight and the divide it up into smaller meals. I know some people don't like to do the hourly feeding and do every other hour and just doubling up on the amount. Just start somewhere and then experiment with what works for you and see how Frankie reacts to the food.
Tina & Sammy
Member Since 2010
If it is possible to segregate your Sugar Kitty while you are at work you can use an auto feeder, but I understand it doesn't work for everyone. I don't segregate Sammy, but Crystal gets her food in the morning before I leave for work and she will eat everything all at once and then doesn't seem to care about food during the day so I don't have to worry about her eating the food I have left for Sammy in the auto feeder.
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