How long on same dose?

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Chris & China (GA)

Chris & China (GA)

Member Since 2013
China has been on .75u Lantus for 3 days now (6 shots) Her numbers have kind of been all over, but you experienced people may see something I don't.

Should I just continue with the .75 for now?

Also,I'm trying to encourage her to eat more at one sitting instead of feeding her 6-8 times/day. I think I read that food should not be eaten 2-3 hours pre-shot, but she's just not a big eater so am trying to figure out what's best for her (and her 2 behemoth housemates.

Thanks again for all your help and advice
 
No food 2 hours before pre-shot. That is so the pre-shot BG number is not food influenced if possible.

Let me look at your SS and get back to you on holding the dose.

You only started the Lantus on 6/5. Stay on the 0.75U dose for 5 full days or 10 cycles to fill the depot.

She has not fallen low, under 50. It that happens, it's an automatic reduction.

Can you get a +2 test every day or as many days as possible? That test gives us a lot of information to work with.
Also, a test just before you go to bed would be helpful.
The testing around nadir somewhere between +5 and +7 is key. Most cats nadir around +6 give or take an hour. Some nadir early like my Wink at +4. ECID.

•Kitty should be monitored closely the first three days when starting Lantus or Levemir.
Blood glucose levels should at least be checked at pre-shot, +3, +6, and +9.
More monitoring may be needed.
•It will be necessary to test kitty's blood glucose levels multiple times per day.
•Learn the signs of and how to treat HYPOGLYCEMIA and prepare a HYPO TOOLBOX.
•Test regularly for ketones and know about DIABETIC KETOACIDOSIS (DKA).
•Use U-100 3/10cc syringes with half units marked on the barrel for fine dosing.
•Feed a high quality low carb canned or raw food diet.
•Feed small meals throughout the day. Some kitties adapt well to free feeding.
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"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.
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Can you get a +2 test every day or as many days as possible? That test gives us a lot of information to work with.
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Will try to get those today/tomorrow

Just a little extra information...my schedule is a little crazy, so when trying to figure out times to give insulin, the best times that work for us are 11am-11pm....that's the reason there's no AMPS value yet...still a little over an hour away

The testing around nadir somewhere between +5 and +7 is key.
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Will try to get some of these values into the SS too
 
my schedule is a little crazy,
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Understood.

Family, work, volunteering, hobbies, social life, friends, taking care of my home, doing a few more things on the 'honey do list' and I'm the only honey, taking care of my gardens, grocery shopping, paying bills, playing with the cats, feeding the cats, grooming the cats, letting the cats out onto the porch, testing cats, scooping all those litter boxes, doing laundry with all those cat towels, cleaning up kitty vomit - on the carpet - again - 10 minutes before you have to head for work, sweeping the porch so the cat doesn't eat another dried up pine needle and vomit on the carpet again...............................and all the other things we do to manage our hectic busy lives.

I'm sure you have your own list.

The suggestions we give are just that. Suggestions. If there is something we say that you do not understand or want more of an explanation as to why we ask for certain tests, please ask. You are not a mind reader and neither am I. And I don't speak cat very well either so can't talk directly to your cat.

the best times that work for us are 11am-11pm....that's the reason there's no AMPS value yet...still a little over an hour away
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Maybe note that somewhere on your SS?

ETA: would you please add the Lantus to your signature? Thanks
 
Thanks Deb&Wink!

Will try to get a +2 and at least a +6 or +7 as the day goes on

Added Lantus to sig too :smile:

Family, work, volunteering, hobbies, social life, friends, taking care of my home, doing a few more things on the 'honey do list' and I'm the only honey
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What's this "Social Life" you speak of?.... :lol:
 
Getting a +2 number does not give that much info; both of my cats were still rising as it takes more than a couple numbers for insulins to kick in and show much effect.

How to do a Curve
Example of a typical curve:
+0 - PreShot number.
+1 – Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 – Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.


It's a good idea to get a couple curves.... once every week or 10days is good.
Curves will show you the general area where your cat's nadir is located. One of my cats was around +5 and the other was at +10 or later, so it's good to stagger your tests during the cycle, and not testing always at +6..... one day you can get 2, 4, 7, and 10, then the next time, get a 3, 6, 9.
Over time, all of your spot tests will show you a pattern for your cat.

Gayle
 
Since you are at the beginning of using Lantus, if you are willing to gather more data, that is great.

An alternative to doing a full curve, is to get those random spot checks. Vary the times you test. The often neglected +10, +11. Take a random +5 instead of a +6. When first starting out, I think a curve gives us some useful information after the depot has had time to fill. So after the first 5 days, then a curve.

Blue said
so it's good to stagger your tests during the cycle, and not testing always at +6..... one day you can get 2, 4, 7, and 10, then the next time, get a 3, 6, 9. Over time, all of your spot tests will show you a pattern for your cat.
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I agree, vary the times. You do not have to test this many times every day. The 3,6,9 tests are a mini-curve. Testing every 2 hours is a full curve. The chart with the list of a 'typical lantus curve' that Blue gave you is not to be confused with a testing curve. They are two different things. That list is more of a typical lantus cycle than anything else. Of course there is ECID. ;-)

Curves are not of much use if you have skipped a shot. I don't think Curves are of much use if your cat is bouncing.

Here is where the peer review and varying opinions come in to play. Blue does not think getting those +2's give you much information. Marje and Sienne and now me, do believe they give you some good information in relation to the pre-shot. They can tell you if the cycle is going to be normal, active or very active.

So it's up to you to decide if you want to get those +2's.

There are two approaches to using Lantus insulin, the SLGS (Start low, Go Slow) method or Tight Regulation. Usually, your work and life commitments will determine which is a better fit for you.
 
"Typical" +2 is for the number to be right about the same as the preshot number was.

A +2 that is lower, especially significantly lower than the Preshot number, can give you a head's up that the cycle is going to be "active" with a bigger than normal drop in BG later in the cycle (by or before the typical nadir).

That's the value of a +2 test. It may not happen often (the active cycle) but it's nice to have an early warning especially on the PM cycle.
 
OK....updated numbers on SS....did a +2 and a +6


Is it OK for her to eat several small meals or will that effect her numbers? She doesn't eat very much at one sitting

Thanks for all your tips. Hopefully I'll figure all this out soon with your wonderful help!
 
The only time we suggest you withhold food is 2 hours before the pre-shot tests. The tests done right before you give the insulin shot are best taken without a food influence.

It's fine to feed small, frequent meals. Smaller meals throughout the day, help to keep the BG levels more even. It's fine to feed before other tests during the day too.
 
Tomorrow, should I vary it? Maybe +4, +8 and maybe a +10 ??
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Yes, you have the right idea. The only change I would suggest is to get that +6 again. You could skip the +8 if you wanted to. It usually doesn't give a lot of useful information with the Lantus.

So pre-shot, +4, +6, +10. How does that look to you?
 
I'm a little discouraged with today's numbers...they don't make any sense to me, but I guess it's like with the diet change. If it continues to stay in the 300's instead of going down, her body might just be adjusting?

Since after tonight's dose will be her 10th at .75, should I go ahead and increase her to 1 unit tomorrow if her BG is over 200?
 
Wow! Flat cat today. Very flat curve. Looks like an increase may be in her future.

You will be at dose 10 tonight with the Lantus, depot filled or close to it. I'd like to see a couple more numbers before you increase.

Would you be able to get a before bed test tonight? Or maybe something earlier tomorrow morning? To see if China White is dropping low overnight.

I'll look at the SS in the am, before your 11 am shot time.

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.
Click to expand...
 
Would you be able to get a before bed test tonight? Or maybe something earlier tomorrow morning?
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Yes...I'll try to get one between +8 and + 10 after her next .75 unit dose tonight and will update my SS asap
 
Yeah deb and I are thinking the same... A before bed test would be good. We are thinking this could be a bounce, and want to see if and when she comes down..
 
China is on an 11am/11pm schedule for shots, so hasn't had her PM dose yet (gets it about an hour from now) I was thinking I'd get one in the morning, but if you think it would help to get another BG later tonight, when would you suggest?
 
I want them pretty blues and greens too! That's why I thought it was time to holler for help!! I've learned so much from you ladies and before I call the vet tomorrow (it's time for me to check in), I want to know what to tell him...LOL (he does admit he doesn't know everything and I'm hoping he spent some time taking a look at this message board)
 
chrisluvsanimals said:
I want them pretty blues and greens too! That's why I thought it was time to holler for help!! I've learned so much from you ladies and before I call the vet tomorrow (it's time for me to check in), I want to know what to tell him...LOL (he does admit he doesn't know everything and I'm hoping he spent some time taking a look at this message board)
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You are plenty ready for an increase in the dose. I'd say to go with the 0.5u increase but maybe you want to get right onto the lines on the barrel of the syringes and it will make a whole lot easier for measuring.... going to a 1u dose would be great.

The reason for the before bed test.... several cats go lower at nite, so it's advised to get a +3 or later because there have been many a time when an owner got that nite time test and found the cat was quite low..... owner had to crack open some higher carb food to give the cat. So that's the reason it's good to get a test at nite. I set my shot times and bed time so that I could get a +3 or +4 for my cats each nite, and then I could go to sleep and not worry about waking to a sick cat in the morning.

As for blues and greens, it's really up to the boss and that's the cat. None of us know for sure how long our cats have been diabetic, so we can't say how long it will take for our cat to accept and realize the benefits of the insulin and come down to better numbers, plus stay there. You can see that one blue you got but it was followed by a small bounce up again..... that should let you know that your cat's not used to good numbers, so it will take a bit of time...but slowly, you will see improvement in your cat first, the numbers will follow.

When you are testing in the start, it's good to get tests at all sorts of diff times. The 3/6/9 mini-curve is good and so is the full curve at 2/4/6/8/10, but the random ones will also contribute to a full picture. Whenever you think you see your cat acting oddly or diff, take a test. All data is good.
By lots of random tests, I found that one of my cat's nadir was around +5, and the other was around +10 or later.

Good luck with your dose increase.
Gayle

ETA: to say that a curve is of no use after a skipped shot.... not true. You skip a shot because your cat is too low for a shot, but maybe your cat climbs high by +1, or +13 if you skipped, so you will learn that you could have delayed the shot or given a partial shot. It is quite important to know what happens with your cat after a skipped shot because it helps you to make more informed decisions in the future.
 
OK...latest numbers updated on the SS (2 and 5am are strange hours to be up poking my cat....lol) but she's down, so do I increase with the 11am shot to 1 unit or what?

Thanks again
 
On the increase for today, we don't know yet.

Since we let the depot fill for 5-7 days, we are just at the 5 day point now. Now, any doses you give will be going to keep the depot at an even keel but also more of the shot will be put to use right away.

The high flat curve on Sunday AM looked like maybe an increase was in order, but I wanted to see some of the overnight action. Could have been a bounce.

You got some much nicer numbers overnight, down to the low yellows.

IF an increase is due, and we are waiting on that pre-shot to see, I would not go up more than 0.25U at a time. This is based on the nadirs you have been getting and the dosing protocol. Going up a 0.5U at this low dose of insulin does not follow the protocol and would be too big of an increase right now.

If nadir blood glucose concentration 200-300mg/dL (11-17 mmol/L)
Increase every 3 days by 0.25-0.5 IU depending on if cat on low or high dose of insulin
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We are trying to make small adjustments in the doses, so we do not bypass a lower dose that would be the right dose for your cat China White.
 
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