I want to increase her dose

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Karin&Jesse

Member Since 2014
I'm posting over here from the Health board as suggested. I think I should increase Jesse's dose by .25. Should I wait one more cycle after not giving a dose a few days ago or is it okay to increase tonight? I'll be doing a few more tests today. I know I should try to test during the night but since bedtime is only about an hour after dosing, I think I will try to check early in the morning which would be around +8 or +9.
 
Since I seldom make it over to Health these days I'm curious why did you cut her dose in half? Was it because you felt it was started too high and that you might have skipped her ideal dose?

The reason I ask is because based on her spreadsheet she just started to get some really nice numbers at 2u but then you sliced it in half.

If you are looking at starting her over and gradually increasing to eliminate the possibility of overdose when you raise would be based on which protocol you're following. Over here we are Start Low Go Slow. With our protocol you would need to hold the dose for at least 5-7 days after a skipped shot, then run a curve and based on that nadir adjust the dose. It's been awhile since I've followed Tight Regulation (they are a separate forum) but I believe they also hold for 3-5 days after a skipped shot.

Lantus doesn't have an immediate response on BGs as it is a depot insulin and takes time for that depot to adjust. Every time you change doses, give a reduce (chicken shot) dose or completely skip a dose the hold time clock resets.

When working with Lantus patience is your best friend. She didn't become diabetic overnight and she isn't going to be "cured" overnight either. This is a marathon not a sprint.

Mel and The Fur Gang
 
The vet recommended 2 U first once a day then 3 days later said to double it to 2U 2X a day based on one reading that I took. On the health board I was advised that 2U was too high and to start over with 1U. So, I did. I also thought she was doing better on 2U 2X a day. So, now I think she should be higher but I should do it in small increments. I think the relaxed method is best suited to us. I needed to know if I had to start over with the hold time when I chickened out and didn't give her a dose on 1/12 am. I feel bad making her wait.

BTW. She weighs between 6 and 7 pounds and is 12 1/2 years old.

I should also add:
I live in a very very small rural community. The nearest vet clinic is an hour and half drive. The vet here is a true country vet. He has a mobile clinic and travels to small towns for people who do not have easy access to a vet. We were lucky because he moved into our town a few years ago - he's still a half hour away but that's considered close. I didn't even want to get a female dog until he was here because it was nearly impossible to get an animal spayed. I can pretty much bring an animal in anytime that he is not on the road and I have needed him in several emergencies so I'm grateful that he is here. If I did not have him here, I would not be doing this. Trying to deal the clinic so far away would be too stressful for the cat and me. He is pretty cool with me taking charge to some degree of my animals' care with his help.

I understand that it will take time and that managing diabetes in a cat is challenging. Living out here makes it double challenging. I get discouraged because I wonder if I am doing her any service when I don't know what I am doing.
 
Okay that answers the questions I had. :-D. Starting over and going back up slower is fine. Just wanted to be clear on the why. Occasionally we see cats that vets do some weird dosing because they don't truly understand Lantus.

Anyhow...I would leave her where she's at for a couple more days to see if she comes back down again just to make sure that blue preshotthat caused you to skip was a fluke. Because if it wasn't a fluke then she can get there on this dose she just needs time to adjust.

On thing that happens often in the beginning is they drop into nice numbers and the bounce into high numbers again because normal doesn't feel normal to them anymore and their bodies panic. I think of it like driving on the highway...When you first get to 75 mph it feels really fast but after driving for a few miles it starts to feel normal and not dangerously fast but you come to a construction area and have to slow down to 55mph even though you haven't slowed down that much it still feels like you're crawling along. Same thing for a sugarcat. Long before we know they're even sick they've been in high numbers so we add insulin they drop lower than they've been in awhile their bodies think this is now a hypo situation and it sends out stored sugars and counteregulatory hormones. So we just have to wait those bounces out and they can take up to 72 hours to clear.

If she merely bounced off that blue preshotthen in another day or two she'll start giving you better numbers.

Mel and The Fur Gang
 
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