Guidance would be amazing!

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CaitLovesMo

CaitLovesMo

Member Since 2022
Hello everyone!

This is my first time posting here. I hope it is okay that I didn't make my Mossimo (Mo) a complete profile yet.

Mo was diagnosed on January 17th... he started on 1 unit of lantus and then by 2 vets it was recommended to go to 2 units. I did not feel comfortable and went to 1.5 unit.

I can't get an answer from my vet and not only do I want to know, but I am going out of town and my mamma will be taking care of him for 5 days... I am terrified but I will be writing everything down for her.

I am sticking with 1.5 for now. His numbers have improved greatly. I am unsure of when not to give insulin, when to reduce the dose. I know 60-120 is normal so that means no insulin? Then I am curious of range for different amounts of dose..

I hope you guys could help me. I have honestly been guessing. Here is is sheet below.

https://docs.google.com/spreadsheet..._pZf9HmUCy2J_yrOaclzHIPI7E/edit#gid=361360320
 
Hi there!

Did something happen between the 4th and 5th? Asking due to the somewhat drastic change in numbers, but also due to the inappetence/lethargy/etc notes in the spreadsheet.

You currently have the 1.5U depot still affecting numbers, thats the one tricky thing about Lantus. But shooting the reduced dose was the right call given how new you are/trying to figure things out. If you get an unusual numbers, you can always stalk without feeding and post here for help - just flag it with the "?" Prefix (when we scan the board we look for 911s first, then ?s, then everyone else).

Others will be along that would be better to advise at these smaller doses, but at this point I'm thinking hold the 0.25U and see how he does.

Yes, 60-120 is normal range but that does not mean skip insulin. The goal is to get to an insulin dose that keeps them in that normal range nearly all the time.

I will give quick summary of dosing methods in a minute....

@tiffmaxee @Bandit's Mom @Christie & Maverick
 
TR:
- must be on low carb wet diet, completely. No high crab treats, etc . LC freeze dried is fine
- Reductions are below 50 on human meter. So any time you see under 50, next shot is reduce by 0.25U. Alternatively, you can try a reduction if they are in mostly green numbers for 7 days. Once you get to lower numbers, it goes 0.25U to 0.1U, to a drop dose sometimes.
- Doses are held for 3-5 days. Once you see green like you are, you hold a dose for at least 10 cycles from when you got the green.
- Target BG range is 50-99 ish, what we call the pancreas-healing numbers. Best chance of remission between the two methods.
- 4 tests minimum per day. The two preshots (should be fasting for 2 hrs), and then at least 2 more each cycle (non fasting). You want to vary the times of testing - so a +2 here, a +5 there, etc. In lower numbers, the amount of trying typically increases Now, with the numbers you're getting, I do think remission is very possible. The "downside" is that can mean a lot more testing to keep her safe.
- no customization

SLGS:
- 0.25U reductions any time below 90, or the mostly green mentioned above
- Doses are held for a week, at which point you do a curve and decide whether to increase. Downside is this can take longer to get better numbers.
- Testing - the two preshots, plus the weekly curve. Obviously, any extra testing is always helpful.
- Target BG range is 90-120- ish. This is because of less testing, you need a cushion to keep them safe. The higher BG range is also reason the chance of remission lower with SLGS.
- You can customize and change reduction point, but if you do that we will push for extra testing

Please do double check those lower Libre numbers with a human meter, Libres are known to read artificially low in lower numbers. I personally have had more bad experiences with Libre data being inaccurate vs human meter at all numbers on this forum, but there are plenty of people who really like them and haven't had issues.
 
FrostD said:
Hi there!

Did something happen between the 4th and 5th? Asking due to the somewhat drastic change in numbers, but also due to the inappetence/lethargy/etc notes in the spreadsheet.

You currently have the 1.5U depot still affecting numbers, thats the one tricky thing about Lantus. But shooting the reduced dose was the right call given how new you are/trying to figure things out. If you get an unusual numbers, you can always stalk without feeding and post here for help - just flag it with the "?" Prefix (when we scan the board we look for 911s first, then ?s, then everyone else).

Others will be along that would be better to advise at these smaller doses, but at this point I'm thinking hold the 0.25U and see how he does.

Yes, 60-120 is normal range but that does not mean skip insulin. The goal is to get to an insulin dose that keeps them in that normal range nearly all the time.

I will give quick summary of dosing methods in a minute....

@tiffmaxee @Bandit's Mom @Christie & Maverick
Click to expand...

Nothing happened between the 4th and 5th so I was definitely confused. He is on a strict schedule and same diet every day. Not even getting treats anymore, he actually refuses them.

I am glad the .25 was a good call. I didn't want to give him 1.5 because I had to leave for work and didn't want him hypo. His first dose was 1 unit. 2 vets told me to go to 2 units but I refused and did 1.5. I now learned it should have been 1.25. I hope I didn't do damage.

So are you thinking no matter what the number is to give him the .25 dose??? I am still confused about all this and trying to comprehend it... my mom is watching him next week so I am terrified because i don't even have to figured out...
 
Welcome. We ask that all start your n the main/health fury, with an introduction. It’s great that you have a spreadsheet. You also need a signature and decide on a method before we can advise you on dosing.
 
CaitLovesMo said:
Nothing happened between the 4th and 5th so I was definitely confused. He is on a strict schedule and same diet every day. Not even getting treats anymore, he actually refuses them.

I am glad the .25 was a good call. I didn't want to give him 1.5 because I had to leave for work and didn't want him hypo. His first dose was 1 unit. 2 vets told me to go to 2 units but I refused and did 1.5. I now learned it should have been 1.25. I hope I didn't do damage.

So are you thinking no matter what the number is to give him the .25 dose??? I am still confused about all this and trying to comprehend it... my mom is watching him next week so I am terrified because i don't even have to figured out...
Click to expand...
So the best thing is consistency, picking a dose and sticking with it until a reduction is earned or an increase needed. The exception being those lower than usual preshots - we say when you're new and get a number below 200, stall without feeding and post for help. Over time you gather data to safely shoot lower. You've already shot some lower numbers so it's good data to have!

Most caregivers have some time to figure out what method works best for them, but with the numbers you're seeing you basically have to pick one now before we can give really sound advice. Per SLGS, he's earned a reduction or two. Per TR, hmm maybe technically not but something is happening with the overall BG that warrants some thinking.

Let the others advise on dose, I try not to advise on dose unless someone is in a pickle at shot time. It really does depend which method you want. 1.25U seems a bit too high to me too unless the Libre is wonky. And with you going on vacation next week, we usually do a lower vacation dose to keep them safe. So to me that's around 0.5U, but I don't see the harm in sticking with 0.25U for a few cycles and see how he does.
 
I will say that 1.5 was too large a dose to kudos to you for not listening to the two vets. What have you been feeding? Has there been a diet change since starting insulin?
 
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