Dosing Help

[Crystal & Leo]

Leo recently switched to Lantus 1U from Vetsulin 1.5U and has been too low to give insulin some evenings/mornings. Skipping the dose makes his BG go up high. I was told to feed him twice a day (morning and night.)

Should I be feeding him during the day to avoid a low PM/AMPS...or should readjust his dose to .5U?

 

[Gill & George]

Have you ready the stickies on TR and slgs?

These are the two dosing strategies most of us follow, the advice would be different depending on which one you want to follow
LANTUS & LEVEMIR - START LOW, GO SLOW METHOD (SLGS)

LANTUS & LEVEMIR - TIGHT REGULATION PROTOCOL (TR)

On TR you would hold the dose, when you are data ready(and you are not) you would slowly shoot anything over 50. If you wanted to follow TR you would need to make sure you get at least one test in every cycle, a few in every cycle would be better, if possible, so that you can figure out what is going on. Those blacks I. There are likely a combo of boy ce and skipped shot, and it does have me wondering if he may have dipped even lower in the pm cycle of 10/18, perhaps into low green, and perhaps a reduction is warranted, can't say for sure, be ause we are missing the data, in contrast to you previous insulin, dosing is based on how low (Nadir) the dose is taking kitty, usually that's around the +5+6 mark.
Any chance you can start getting more midcycle tests?

With SLGS the guidelines suggest reducing if you see a number below 90. So if you were following slgs a reduction to 0.75 has certainly been earned.
With SLGS you hold the dose for a week (unless they earn a reduction), run a curve once a week in an attempt to find the nadir to help you with your dosing decisions. That said, a little more data during g the week can help with your decision, it can make this happen clearer, especially if kitty is boy co g on the day you run a curve.

all things considered, my advice would be to take the dose down to 0.75, and test a little more.

Just a thought, are you using U100 syringes ?

with kitties new to lantus we usually recommend that the CG post for guidance when faced with a lower than usual PS.

 

[Chris/China (GA)/Garfield]

As far as feeding goes, it's actually better to feed multiple small meals instead of two big ones.....with Lantus, it's not important that they eat a "big meal" before shooting like it is with Vetsulin.

Lantus is more gentle and usually takes 2-3 hours to start to "kick in", so you have several hours to get food into them.

Small meals are easier on the pancreas too. Most of us feed at least 4-6 times a day. The only time you don't want them eating is the 2 hours before Pre-Shot testing times.

I think I'd go down to .75 .....getting PS's too low to shoot is a good indication that the dose is too high (at this point in your diabetes journey anyway....eventually we'll shoot those lower numbers)

Also, make sure to get at least a "before bed" test on the PM cycle.....most cats go lower at night and without that test, there's no way to know what's going on while you're sleeping. IF that "before bed" test indicates he's dropping too much, you may need to set an alarm to get more tests later in the cycle

 

[Sylvie]

noticed on your spreadsheet you are feeding HSD dry sensitive, that is really high in carbs (over 30% i believe) and it may be partially why your leo's numbers are all over the place?? Personally i let my kitty free-feed on low carb dry food (YA & some EVO) during day and overnight usually and feed him FF turkey and giblet classic wetfood a handful of times during the day.

I use lantus too, and half the dose when under 150 (haven't had under 100 but, won't shoot when we do) and i minus the dose by .25 at night sometimes if numbers are between 150-180 or so for my piece of mind since i won't be up to check on him a nadir time.

 

[Tricia Cinco(GA) & Harvey]

Changing the dose frequently, and shooting different numbers day and night does not work well with Lantus. It works best with consistency. The depot can't keep up with a lot of changes, and you will get really wonky numbers. You need to find a dose you can safely shoot consistently. The more data you have, the clearer the picture becomes. Remember, Lantus dosing is based on how low the dose takes the cat, with some consideration given to the preshot numbers (is it safe to shoot?).

 

[Gill & George]

HSD dry sensitive, that is really high in carbs (over 30% i believe

God spot Sylvie. One thing I would add though if you do take HC food out of the picture, please do it slowly and be extra vigilant with numbers, removing it suddenly can have a huge impact on BG,

With dry in the picture, slgs is the strategy to follow. So definitely reduce the dose to 0.75.
I agree with Tricia, shooting consistently works best with the dosing strategies we follow on the board. I wouldn't recommend routinely shooting different doses am and pm cycles.

 

[Dyana]

Her signature has Transitioned to FF 7/14/17, so hopefully dry is now out of the picture. If it is not, I agree with changing to a lower carb food slowly and testing more often because that change can lower the BG significantly, as stated above.

 

[Gill & George]

Her signature has Transitioned to FF 7/14/17, so hopefully dry is now out of the picture. If it is not, I agree with changing to a lower carb food slowly and testing more often because that change can lower the BG significantly, as stated above.

Thanks Dyana, missed that, that's what happens when I post before I've had my coffee