Jan 8 - Bacardi's 6th day on Lantus - not dropping under 300. Dose increase tomorrow?

BacardiTheGreat

Member Since 2018
Hi guys, so we have just finished our sixth day on Lantus, so according to TR it's time to increase the dose. It's my first time increasing, so please someone more experienced confirm: vast majority of his BG tests were above 300, and that means that we should increase by 0.5 units, right? So, starting from tomorrow it's 1.5 units twice a day, isn't it? I hope I'll get him a bit lower. Today he played like a kitten for the first time after the switch (previously on Caninsulin he used to play every time his BG dropped to around 90 - I assume because he felt good, so good news - he probably finally felt good again today!)
 
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The TR guidelines for increasing are :

  • After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Lantus dosing decisions are made based on nadir (lowest point in the cycle), not the vast majority of numbers.

Playing like a kitten is a good sign :cool:
 
I see some yellow’s on Bacardi’s spreadsheet. Ask yourself the question “how low can this dose take my cat”. The answer is below 300, when he’s not bouncing,
 
I can definitely try that, although I only have 1 unit increment on my syringes. So, the best I can do is to eyeball it ;) (smaller syringes are on the way, thanks to Bron&Sheba, who told me where to get them. It's a different country though, it seems to me like the vets here just know Caninsulin...)
 
So in the TR description:
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
does this essentially mean that if ANY nadir falls under the number (200 or 300), you automatically "disregard" the rest, even though the vast majority was higher? Trying to understand the method and this is the part where I am still not sure. So pretty much "look for the lowest number you have gotten and adjust the dose according to that"? Do I understand it correctly now?
 
Are you using the BD Microfine syringes? If so, take a look at the paper on Management of Diabetic Cats that is attached to the TR protocol Sticky Note. There is a section on fine dosing with a pointer to a downloadable ruler that can be used with those BD Microfine.

For your other question, yes, disregard the nadirs on the bounce cycles and concentrate on how low the dose can take the cat when not bouncing.
 
@Wendy&Neko thank you Wendy. I still don't completely understand bouncing..I guess that's any number that is higher than the lowest numbers I got? I have ordered the BD Microfine, they are on the way now, but still waiting (hopefully I'll get them by the end of this week). So for tomorrow it's my 0.5ml ones (1 unit increments). I'll do 1.25 (I did the same with Caninsulin and was told that consistency in dosing is more important than 100% accuracy)
 
Yes on the consistency. Some people full a blank syringe with coloured liquid to compare to, or take a picture on their cell phone.
 
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