Lilly`s BG numbers

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terri1962

terri1962

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Lilly`s BG have been below 200. I have still been giving her .5 units if insulin. Her numbers were never very high pre insulin. If I went by what my vet told me I would be giving her 1 unit twice a day which I decided not to do. My vet would not even look at her numbers that I had written down she said just give her 1 unit twice a day.
Could those of experience please review her spreadsheet and give me some thoughts? I have read I should not be giving the shot if she is below 200 but most of the time she is below 200.

Terri

Here were her numbers pre insulin
9/28 190
9/29 155
9/30 193
10/1 191
10/2 209
10/3 210
10/4 234
10/5 230
10/6 219
10/8 215
10/9 194
10/11 207
10/12 208
10/15 187
 
I can only see three days on the ss, so not a lot to go on, but it looks like she can handle that dose on blue preshots. If you can get more tests around nadir you would know for sure.
For safety we usually tell people not to shoot under 200 until the data is there to have confidence that it is safe to do so.
Good call on ignoring the "1 unit" advice from your vet. Given the numbers you are getting with half that dose, 1u would be too much.
Carl
 
Hi Terri,

Are you getting advice over on the Lantus forum also? They know your insulin best. I think your numbers look fine for early on. Lantus users with data do shoot below 200, once they have a general idea of how that kitty is responding to the insulin. You may have already seen this document on dosing Lantus:

"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.

Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose.
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.

Reducing the dose:
If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.
If an attempted reduction fails, go right back up to the last good dose.
Try to go from 0.25u to 0.1u before stopping insulin completely.

And this document on handling low numbers: viewtopic.php?f=9&t=147


A general observation. I remember Lilly is hard to test, but the more numbers you get, the more you will feel confident about proceeding. So anytime you can get a number at night mid cycle or a couple numbers mid day, it will help you see what is happening.
 
Sue

No I posted a couple times on the Lantus board but I am not following the Tilly protocol and can not test numerous times a day so I will be posting here. I do not have the most cooperative cat. She spends most of her time hiding now because she thinks I am abusing her when I test her and give shots. She rarely comes out of my bedroom anymore.

Terri
 
I know it is hard to test Lilly. Is there anything she likes - a special food treat or brushing? Niko loves to be brushed so brushing him before and after would be a good way to get him to relax during testing. Have we seen if anyone lives near you? Sometimes just watching someone else poke their kitty and then trying on their cat will give you more confidence in doing your own. Have we suggested the kitty burrito? We had to wrap Oliver up in a towel with just his head showing at first. After a while, once he understood his favorite treat was coming after, we didn't have to use the towel anymore.

I know it seems like we want too many tests. But it is difficult, and in fact, dangerous, to give a dose without knowing something about how it works in her body. The small doses are especially hard to manage because it is so easy to give too much at those low numbers.

Looking at your chart, she is not doing badly. Lantus does take at least a few cycles to build up the shed and settle in. You are getting a nadir which really helps. If you could add to that with a pm nadir or even any pm number, that should be enough data for the Lantus folks to help you figure it out.

Are you worried you are giving too much or too little?
 
Looking at her spreadsheet, even with limited data, my concern is that when the Lantus gets to a stable level at 0.5 units in 3 - 5 days, Lilly may have too much in her system. She's already showing a midcycle green at the 3rd cycle of 0.5 units. The experiences Terri has reported before show Lilly to drop dramatically on just one dose - a very sensitive cat.

Momma of Muse suggested 0.25 units on the previous thread and I concur, especially since I know Terri can't be home around the likely nadir times.
 
I will try to dose at .25 tonight as suggested. It may take me a while to see that on the needle even with reading glasses. I would guess I should keep her at that dose. I wish they made better needles with smaller markings for those of us who don`t see to well.
Sue
I am worried with her low numbers she is still getting to much insulin and that seems to be the general concern here on the board with the more experienced people.

Terri
 
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