Monty earned a dose reduction (again!)

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Tom & Monty

Tom & Monty

Member Since 2020
Good news for Monty, he's going down from 1.25U Lantus twice a day to 1U.

I shared my chart with the vet and he's asked for more mid-day numbers, but he also really wants a curve and a dose of 1.25 is causing a lot of skips at the moment because of him being in the healthy range every few days.

He offered me two options:

1) inject once a day
2) inject twice a day with 1U

I chose option 2, and he wants me to wait 10 days on this dose and if I don't skip too much he wants a curve in 10 days.
 
You definitely need to get some tests in during both the cycles.
At the moment we have no idea what the insulin is doing to help the BG during the cycles. It could be dropping dangerously low and then coming back up again for the preshot.
Lantus is not dosed on the preshot number but the nadir (lowest point in the cycle). At the moment you are changing the dose on what the preshot BG is. This is why you are not making progress.
Im glad you chose twice a day dosing as once a day doesn’t work well in a cat.
 
I do. I was struggling to convince my partner to help me do this but succeeded this morning by giving her a 101 on feline diabetic dosing and she now agrees it's important to get some tests in mid day.

In other news he's 8.8 (156) this morning after only a token dose last night. It's very close to 150 and I won't be indoors today between +2 and +6 so I'm going to skip to be on the safe side.

I want him to be on a stable dose so that I can get a curve in but so often he's getting token doses or skips. I'm considering just dropping his regular dose down to 0.25 or 0.5 (since these current tokens ususally result in good pre shot PMs) and working back up from there with stability. What do you think?
 
Tom, have you chosen a dosing method to follow?
Here are the 2 dosing methods. Have a read and see which one suits you. If you follow one of the methods you will know where you are going instead of just stabbing in the dark
http://www.felinediabetes.com/FDMB/forums/lantus-basaglar-glargine-and-levemir-detemir.9/
http://www.felinediabetes.com/FDMB/forums/lantus-basaglar-glargine-and-levemir-detemir.9/
You definitely need to chose a dose and stick to it unless Monty drops too low. Once you have chosen a dosing method that will tell us what the reduction number is, so try and choose a method as soon as you can.

Has the vet ever mentioned that Monty has ever had ketones.? It’s important we know if he had as that changes things.

You don’t want to be skipping doses if you can help it as it messes the depot and you won’t get consistent numbers.
It’s looking like he is doing quite well on 0.5 units so you could try that dose and see what happens. But you need those mid cycle tests in each cycle otherwise you don’t really know if the dose is working.
For the pm cycle, try and get a before bed test in every night...that will help. If that test is a lot lower than the preshot then you know that Monty will probably drop lower and you will need to set the alarm and get up and test again to keep him safe.

Let me know what you think.
 
I read those dosing methods earlier this morning and I'm thinking SLGS.

His numbers have been so inconsistent recently because of a pancreatitis flare, then a switch to Lantus, then a second pancreatitis flare. He's almost fully recovered from pancreatitis, he's no longer taking any pain, nausia or appetite drugs and he's eating a healthy amount again. He lost 400g in weight from the two flares but at weigh in yesterday he's gained 150g of that back so far. I say he's almost recovered because he's not as playful as he was, however yesterday he was willing to play for 5 minutes.

Because of these circumstances it feels like I'm trying to find a new dose for him, perhaps "starting" on 0.5 makes sense. He was initially on 2.5U Lantus but he's rather rapidly getting lower pre shoot BGs over two weeks.

As for ketones, my vet tested a few weeks back during each Pancreatitis flare and he came up negative both times.
 
Good there were no ketones.
If you choose SLGS you will hold the dose for 7 days then do a curve.
Try and get those mid cycle tests in as well though.
If he drops under 90 (5) you reduce the dose.
I’m glad he is eating well again and seems better. Pancreatitis is not a nice disease. Sheba used to get flares about twice a year. I felt stress sometimes brought it on.

Would you like to start posting over on the Lantus forum? There are lots of experienced people over there who can help you at all hours of the day. Most people over there post each day, then everyone gets to know you and Monty. See what you think.

How are you situated? Are you home most days? Or out at work most days?
 
Ok thanks I'm going to dose him at 0.5 for now and start mid cycle tests tomorrow (I'm out most of today).

In two weeks I leave my current job and start a new job that is entirely remote working so I'll be around for mid cycle tests. My difficulty in doing mid cycle tests is not availability but a combination of:

1) Being unable to test alone, I need more practice, I adopted Monty 7 months ago at age 11 (along with his sister). He's not a "loving" cat in the sense that he won't sit on people and he likes petting only in short bursts. He is however VERY tolerant of me and lancets and has never once swiped at me, he just tries to escape when it's stabby time. I've tried treating him before during and after but he's just learned to associate me holding chicken with being poked.
2) my partner is less willing to change her lifestyle to accommodate him, it was a while before I could convince her to help me test him and I've only just convinced her to help with mid days
3) she's only at home in the day during the pandemic and will eventually return to her office, at this point I'll need to be able to test solo

At the moment we're testing the paw pad because he seems less bothered by that, but given that he doesn't like being picked up or sitting on me I need to get better at ear testing solo.
 
bcat said:
Ok thanks I'm going to dose him at 0.5 for now and start mid cycle tests tomorrow (I'm out most of today).

In two weeks I leave my current job and start a new job that is entirely remote working so I'll be around for mid cycle tests. My difficulty in doing mid cycle tests is not availability but a combination of:

1) Being unable to test alone, I need more practice, I adopted Monty 7 months ago at age 11 (along with his sister). He's not a "loving" cat in the sense that he won't sit on people and he likes petting only in short bursts. He is however VERY tolerant of me and lancets and has never once swiped at me, he just tries to escape when it's stabby time. I've tried treating him before during and after but he's just learned to associate me holding chicken with being poked.
2) my partner is less willing to change her lifestyle to accommodate him, it was a while before I could convince her to help me test him and I've only just convinced her to help with mid days
3) she's only at home in the day during the pandemic and will eventually return to her office, at this point I'll need to be able to test solo

At the moment we're testing the paw pad because he seems less bothered by that, but given that he doesn't like being picked up or sitting on me I need to get better at ear testing solo.
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It might be an idea when you are next at the pharmacy to pick up some Ketostix so you can test the urine for ketones since we are reducing the dose of insulin. It’s a simple test and to eliminate ketones is important, as they can appear if there is not enough insulin given in some cats.

With the testing of the BG, are you offering a small treat as you test?
When I first started testing I used to get my husband to help me but I soon realised that he was not going to get up early in the morning or in the middle of the night to help every time so I just had to do it myself. Once I got myself sorted I was fine.
I used to kneel then sit on my heels and put Sheba in between my legs facing away from me so I had her ears in front of me. She couldn’t back away as I was there and if I had my hand gently around her chest that kept her there. I had all the things early to go and I’d give her something small to eat and while she had her head in the plate I would test her.

You are doing a good job. It’s not always easy when you haven’t got a second person.........my husband eventually started testing the BGs himself when I had to go to hospital for a week and he became very good at it!
 
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