Mr. C - Dosing Help Please

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Sarah Wykhuis

Member Since 2022
Hi Folks! I'm fostering a cat who came out of remission August of this year. We're a week into this journey, but I'm a bit concerned about his appetite this past week. He threw up several times Monday morning, seemed fairly normal Tuesday & Wednesday, but I struggled with him yesterday and today. Syringe fed some two nights ago and yesterday. He did start eating small amounts last night. Gave him some Mirataz yesterday afternoon, so not sure if that played into him eating, but I imagine it's likely.

Anyway... I am really just looking for dosing advise. We're doing Glargine. His numbers are bouncing around (which I'm less concerned about than his not eating). His vet told owners start at 1 unit 2xday (which is what I think they were doing, sans testing, about 3-4 years ago before he went into remission. I started him on .5, and have been as steady with that as I can be w/out a caliper. I'm getting mixed advise as to increase or decrease his dose. I only did .25 last night and .25 this morning. Spreadsheet attached below. I just want to see him feeling better and getting his appetite back, but I would love some guidance RE: dosing. Thank you so much!

Note: Tested last two nights for ketones, and he read 0.

https://docs.google.com/spreadsheets/d/1vSWc1xdAPy9ty4REqfkDS1lGmtLh6nTrwMZeDePj3Zc/edit?usp=sharing
 
Hi Sarah
If you can fill out what we call our signature that will be helpful,it's at the end of everyone's post in gray

To set up your signature which you will see is at the end of everyone's post in gray, click on your name up top and then tap on the word signature and add this information
  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.

Take a look at mine


We don't base how much insulin we give based on the pre shots, we base them on how low the insulin is taking them.
We also increase or decrease the dose by 0.25 units at a time.
I'll give you the link so you can read about lantus/ glargine ,you need to pick one of the dosing methods either TR or SLGS. They will tell you when you need to increase or decrease the dose
Can you get some tests in after the PMPS shot, you are only seeing half the picture, cats usually drop lower at night , even if you have to set an alarm
After you fill out your signature I can tag a few members to look at your spreadsheet

Please read all the yellow stickys
https://felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/
 
@Bandit's Mom could you have a look at this SS please. I don’t think it is one of ours…thanks!

Hi Sarah, it sounds as if you are used to looking after diabetic kitties…have you had one before?
Really glad you are testing for ketones
With the vomiting…have you tried either ondansetron or cerenia for that. If he is nauseated, I would not give an appetite stimulant without giving an antinausea first.
Are you getting dosing advice from another site as well? There is another site which we do not recommend using.
If possible I would try and get at least one test in during the pm cycle as it is just as important as the am cycle. A before bed test is a good idea.
Lantus (glargine) likes consistent dosing so I would stay with one dose for at least 6 cycles unless the BG drops too low.
Have you looked at our two dosing methods. I would suggest reading through them and choosing one of them to follow.
DOSING METHODS

HELP US HELP YOU another useful link for you

Keep asking questions
 
Bron and Sheba (GA) said:
@Bandit's Mom could you have a look at this SS please. I don’t think it is one of ours…thanks!
Click to expand...
Diane Tyler's Mom said:
I didn't think it was our SS either
@Bandit's Mom
Click to expand...
It's not our format, but I am able to see it on my computer. Are you able to open it or does it crash on tablets etc?

Hi Sarah and Mr. C! Welcome to FDMB. I can help with setting up your Signature and converting your SS to our format. Let me know if you need help. :-)
 
Welcome to FDMB!

If you've used or are familiar with other types of insulin, glargine is quite different in the way it works. As Larry alluded to, glargine (and it's biosimilars) forms a "depot" -- this means that every time you give an injection, the insulin forms microcrystals that are deposited into the fat tissue. Not all of the crystals dissolve over the course of the 12 hour cycle -- they continue to dissolve which is why glargine has a long duration and gentle action. It's also why holding the dose for a minimum of 3 days is important since it takes time for the depot to stabilize after any change in dose.

I'd encourage you to take a look at the sticky notes at the top of the Lantus (glargine) board. There is a huge amount of information in those notes including information on the two dosing strategies we use here.

In addition to the testing you're already doing, it would also be helpful if you could get at least one additional test during the PM cycle. Many cats experience lower numbers at night given their nocturnal nature. Further, if you don't have PM tests, you're missing half of your data and could easily miss Mr. C needing a dose reduction.

I'd also suggest that you remove your last name from your spreadsheet. There are too many trolls on the internet and protecting your privacy is important to us.

I'd like to see a few more cycles at a consistent 0.5u dose along with a few PM tests. I'd hate to suggest a dose increase if Mr. C's numbers are lower at night.

Please let us know if you have questions. The members here are very generous with their time and knowledge.
 
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