Lowered dose a week ago, debating increasing?

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Charlie M

Member Since 2016
We did a curve test on Smokey a week ago, his numbers scared us a bit. Not just the numbers, but his body language had been telling us he wasn't feeling well at his mid points as well. We decided to back him off from 2 units of Lantus twice a day to 1.75. We've only been testing randomly, but his numbers seem to be up. It's been a rough week, on top of other changes we've made this week. Trying to decide if we should put him back up to 2units for a while to see if his numbers come back down, or if it's just all the things that have been off this week.

Things that I think are altering test results beyond lowering dose...
1) I've been having trouble with a medical condition of my own this week, my hands have been severely swollen and inflamed, leaving me with a lot of pain and altered sense of touch as well as limited use. My husband did BG tests for me when I was worried about his levels (I wouldn't have been able to test him with the state if my hands), and even had to do a couple of the shots because I couldn't work the syringe (things go much smother for us when I do the shots and test while my husband holds him). Quite a few times when I did the shots I didn't quite get the full dose (just a tiny bit left in the syringe, or pulled the syring out just at the end of the shot and lost a little (just from loss of control and touch in my hands)).

2) We changed syringes this week to make the 1/4 unit easier to hit. We've noticed that it is way easier to hit the exact dose with these syringes. The old ones didn't have 1/2 unit markings, but beyond that the plungers were rounded, but the round was inconsistent, this made it difficult to set the 2 units, and I think we may have been giving slightly high doses before changing syringes. The plungers on the new syringes make it much easier to hit the dose accurately.

3) The medical condition I was talking about above hits more than just my hands, it wakes be up through the night, and leaves me doubly exhausted. I usually give Smokey a 3:00am feeding when I get up to get ready for work. I was having trouble getting out of bed, and by 3:30 he was hitting the dry food before I got up to give him the canned food. So he's been eating a bit more dry food this week. Where he was down to eating almost none until now (we won't remove the dry food, due to extream eating issues we've delt with in the past with him). We also stopped giving him his usual greenies for treats, and had replaced them with freeze dried turkey/chicken instead (but I would put that as a positive change).

Any help making the decision to put his dose back to 2, or try another week at 1.75 would be appreciated.

Oh other info...We talked to the vet after his last curve. She was fine with us making slight changes in his insulin dose. After the last curve results and all the sudden changes in response to the insulin, she has asked us to do random checks around the +6 - +8 hour marks, just incase he's starting to go into remission. We didn't do that this week...we know things are off, and his numbers are up, and it just wasn't possible for me. But did do one today...Yep, it's up. But today ear poke went awesome, so testing is getting easier...this is encouraging to test more, and more!
 
I'm not sure if I should put this here, or in the Lantus specific category?

And a side note, the hands are getting better, so shots should improve now. They're still incredibly sensitive, but the the sense of touch and control is starting to improve, but will still be off for a bit.
 
I'm not an advice giver, but I think you should stay with the 1.75 units until you hear from someone more experienced. since Smokey is eating dry food, you are following SLGS, right? Reduction on the Alpha Trak is 90, so he earned that reduction you gave him.
Due to lack of testing, you really do not know what he is doing with the 1.75, so you should not increase back to the 2units.
I have health issues as well, I know how difficult it can be. Hopefully things will get better for you soon!
@julie & punkin (ga),
@Marje and Gracie
 
I agree with Julie...especially because you have a lot of data missing 6/13-6/15.

Sometimes when a cat's BG drops lower than the body is used to, the liver responds by releasing counterregulatory hormones which bring the BG back up. It's possible that could be happening and you are just catching him when he's at that point.

Also, because Lantus is a depot insulin, if he is getting different amounts of insulin due to syringe inaccuracy or fur shots (understand this is not your fault and you are doing the best you can), than you might see some wonkiness.

I'd hold the dose and try to get a few more tests and definitely do a 12-hour curve, testing every 2 hours, as soon as you can so we can fill in the pieces of the puzzle.

You are more than we,come to post in the Lantus/Levemir insulin support group. There are a lot more eyes experienced with these insulins in that forum and you can also learn a lot from visiting other threads there.
 
I just want to send you a little encouragement - that all sounds very difficult and like you are doing the best you can with your health problems. There are more people here than you might imagine who have illnesses that make caring for their cat more difficult.

You're on the right track and have gotten good advice from Julie and Marje. Feel free to post in the Lantus insulin support group and if there is anything you need help with, just say so. Lots of good people there who are experienced with Lantus.
 
Thank you so much every one. I didn't make it back here before his pm shot (a lot of family stuff going on this weekend). We did attempt to put his dose up slightly...halfway between the 1.75, and 2.0. But your advice did lead me to do kind of a mini curve on Sunday and dropped it back to 1.75 right away. You guys are right!! Things are going better this week...shots are back on track, and testing just finally started going well...I've even managed to do some tests on my own...he's not minding it nearly as much as he was! I'm thinking we will do another full curve this coming weekend (the +4 low is making me think things aren't quite right yet), but will give it the week to settle first...last week was really off.

In the mean time we're thinking well do a preshot before his morning shot (due to work he's on a 5:30am, 6:15pm schedule, so morning is when he's more likely to be lower), and as much as possible a 4-6 hour test(to see how low he's going) at night. Im more worried about morning, because it's his early shot, and my husband will be on his own to deal with it if anything happens. Right now I'm trying to be a bit conservative with the strips...alphas are a bit expensive...but we will have a human meter soon, with much more affordable strips. That will be a big weight off my mind! Will just have to keep the ranges in front of me so I don't get mixed up with readings.

Thank you again! You really helped a lot, and saved me from making a big mistake!
 
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