Lantus dosage advice for Tricky

[liewil]

I just translated Tricky's spreadsheet for August to English, can some Lantus experts maybe have a look and give some advice ?
https://docs.google.com/spreadsheet...5wN3l1a3o3ODdBV0laODRxaHRpZ3c&hl=en_US#gid=19

She seems to do big cycles of going too low and then going too high. I'm not sure whether to change the dose, or even in which direction ... "Bathroom" means she's feeling bad, happens when she goes over 300 (it's dark and lonely there).
Thanks in advance for your input ...

She's on dry Applaws 13,5% ch, 10-9-9 grams every 4 hours, and normally she eats it all immediately. Last night I moved the timer one hour earlier because she dove so low. AMPS was same as PMPS yesterday, but now she's going up again iso. down, as I already expected ...

Should I lower the dose, keep the dose, raise it ? Or change it depending on where she is in the cycle ? I suspected yesterday in advance that she would drop, and today that she would go up, so I could try to predict what's going to happen and adjust dose based on that ... Any insight is appreciated (almost a year after diagnosis ...)

 

[Dyana]

If Tricky had a 45 last night, then that's an automatic dose reduction for a newly diagnosed cat (within 1 year). I would reduce the dose by 0.25 units. If you are shooting 4.25 units now, then you can reduce to 4.00 units. Also, with that 45, we would suggest that you keep testing every 30 minutes at least, until she is a little higher, especially being only at +3 (3 hours after the shot).

 

[Dyana]

According to your spreadsheets it looks like she was diagnosed on August 22nd, 2011. So she's coming up on her 1 year as a diabetic. I think if she was 45 last night, I would still reduce the dose by 0.25. And if you get a 45 again, please post the number in the Subject Line of your first post, so we can help to advise you. We would probably ask you to keep testing until she is up into the 100s or so.

Have a good day.

 

[liewil]

So the idea is : one time below 50, = dose reduction of 0.25 ?
I ask because I was on the lower dose (lowered after the low value on 8 Aug), but then 12 Aug she was above the renal treshhold for 24h, so I increased the dose again ...
And after reducing the dose, wait 3 days before increasing again, or ?

You don't think the big cycles up and down could be because she's on too much Lanus ? I'm thinking about lowering her dose to 3 and restarting the protocol to try and get her to flatten out a bit ...

 

[max&emmasmommie]

Hi. I posted on your most recent thread about Libby's advice on how to handle these bounces that make you think you should raise the dose when you really shouldn't, and suggested that you ask Libby (and Lucy) to explain it to you, but please make sure she understands that your cat is eating dry food, not wet.

Getting a reduction is good, and getting those tests to know about it is even better! You are doing a great job, and I second the advice to keep testing every 15 to 30 minutes when you see a low number like that until you see at least 100. (This is until you find out if your cat's BG is even willing to go past 70 or 80 for the rest of the day after getting a below 50 number. I usually stop at 70 now that I know Max's BG is just going to hang out below 85 for hours and hours. Otherwise, I would shred Max's ears, but this was after days and days of being worried and testing and feeding and testing and feeding over and over to make sure he wasn't going to go below 50 again.)

You can use the hypo procedure with LC good, too, and see if it works or if you need HC to get the cat up, or you can just use HC and practically know he's going to be going up: http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=15887. You do have to keep in mind that with HC, he will go down again faster after HC if, in fact, he's going to go down again, so adding a little LC in there at one of the feeding times (if you get a sufficiently higher number than you did at the last test) is a nice way to help ease the damage to his ears, and it will get some food into him that will hold him longer term until the nadir comes and eases the worry.

Does that make sense?