My Jake

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It would really, really , really ....
Be helpful if you posted your numbers as described previously.
Is 3:30 +5? +6? +7? Or something else?
 
Jakesmama said:
It was at +9 because he was sleeping under the bed at +6
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A 220 at +9 is nice. Right around the renal threshold, the point at which glucose is excreted via the urine. Ideally, you want as much time as possible below that as long as it is a safe number. The specific level varies with the cat and renal function.
 
Would you be willing to add a bit more information to your signature? Like the insulin you are using and the meter you use for testing, any complicating medical conditions Jake has, food being fed. These little tidbits are nice to see at a glance in you signature, and help us to help you better.

Thanks for considering doing this.
 
Morning pre shot Tested at 387 at 6:30 am. I gave him 3 units at 9:pm last night, his shot was 2 hrs late.
I gave him 3 units after his amps and breakfast at 7:00am. I'll test again at 12pm for his nadir.
 
Ok, you're narrowing in on that nadir for Jake. Looks to me like Jake could still be bouncing a bit from that low of 53 a couple of days ago. Let's see how he continues to do and maybe think about increasing the dose in a couple more cycles. Hold steady for now, and let's see what the evening tests show.

Are you able to get any tests at night, beyond the evening pre-shot test (PMPS)? It sure is nice to see that 'one last test before you go to bed test' in the evenings. Many cats go lower at night. If you don't test much in the evenings, you are 'missing half your data' as Sienne and Gabby would put it.

You might want to think about going over to either the Lantus Tight Regulation forum or the Relaxed Lantus forum for insulin specific recommendations. I think it's time you graduated to the next step on the message board. TR is much more active and has many more experienced people to help you out. Relaxed is more laid back and not as active. You can follow either the TR or Relaxed protocol on either forum.
 
Right now I only test 3 times, because I'm tight on budget and his strips are expensive. He tested at 210 at +5 today. When I start my new part time job I will get a different meter with less expensive test strips.

I'll take a peek at the recommended message boards.

Thanks!
 
Jakesmama said:
Right now I only test 3 times, because I'm tight on budget and his strips are expensive. ...
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Yeah, that's why many of us use human glucometers with pet specific reference numbers.
The 2 used a lot here are the WalMart ReliOn Confirm/Confirm Micro or the Prime. If you abhor WalMart, pop online to American Diabetes Wholesale via our shopping link above and look up the Arkray Glucocard 01 and 01 Mini which are the unbranded Confirms (also made by Arkray).
 
Jake tested at 120 at +10.5 (5:30p) then I fed him. His shot is due at 7pm. Should I retest? Or just give him 2u? Been giving him 3u.
 
The pre-shot clues you in if it could be safe to shoot, plus the info from nadir tests.

I'm going to take a stab at it here - you may need to reduce another 1 to 1.5 units.

It takes roughly 5-7 days on the first dose to stabilize and since you started logging at 6 units, then dropped to 3, and are now seeing pre-shots of 102, it makes sense that sticking with 3 units may be too high.

Skipping a dose will allow the buildup to drain out a bit (we call it the depot - crystals of Lantus under the skin which slowly dissolve to take effect). Jake may be higher in the morning, but I think I'd only do 2 units tomorrow morning. If you won't be able to check around the nadir tomorrow, you might even make it 1.5 units.
 
Thank you. I gave jake 2.5u before I got your message. I was contemplating 2u, but was not sure if that would've been too much of a drop. Let's see what happens tomorrow morning......
 
BJM suggested dropping the dose back to 2U and maybe even down to 1.5U if you were not around at nadir to test. I agree with that suggestion.

Lantus is not an insulin where you want to keep changing the dose for every shot. You have that depot or storage area under the skin to think about. Reacting to a higher number at pre-shot and increasing the insulin based on that higher pre-shot is only going to lead to erratic BG readings. You want some consistency in the dosing with Lantus, and you want to base any dose changes on the nadir or lowest point in the 12 hour cycle, not the pre-shot readings.

You need to give the dose changes time to take effect and that can be anywhere from 6 to 10 cycles (3-5 days). This is where you need to borrow a pair of patience pants from my vast lending closet and put them on.

You might want to go over to the Lantus Tight Regulation forum here and read through those stickies at the top of the forum. There is lots of great information there. Not sure if you want to use TR (Tight Regulation) or not, but the folks there can guide you even if you decide you want to go the more Relaxed approach. You may be ready to start posting in one of those insulin specific forum, for more guidance on the dosing for your Jake.
 
So if I drop jake to 2 units twice a day, and his number is high, then I should wait a few days to see if he stabilizes? I gave him 3 units this morning, and at +5 he is at 200.
 
Looks good after skipping. Maybe hold it to see how it shakes out for him, just watch and catch a test between +5 - +7 when he is likely to hit his nadir.

If he goes below 50 mg/dL on a human glucometer, it is an automatic dose reduction of 0.25 units if he is a new diabetic.
 
He isn't a new diabetic. He was diagnosed Oct 2012. Of course I don't know what the criteria is to determine new from long-term.

I've been struggling to get him either stabilized or otj.
 
New diabetic kitty is diagnosis less than 1 year. Long term diabetic is considered to be any kitty that has been diagnosed with diabetes more than 1 year.
 
Jake's amps today were 463. I'm concerned about his high morning numbers. I test him at 6:30am just before breakfast. Then I give him his am shot at 7am. Usually his nadir numbers are good, and his evening numbers are good. Then the next morning his numbers shoot up. I feed him 4x a day. 6:30, 10:30, 2:30 & 6:30. I try to get his nadir around +5 - +6.

Should I spread out his meals a little farther apart?
 
With Lantus, test, feed, & shoot all within 15 minutes, barring a tendancy to hurl breakfast.

With a tendancy to hurl breakfast, feed a teaspoon or two, wait 15 min to make sure it stays down, shoot, feed remainder of food in 1 or more mini meals.
 
You might think about making changing that 2:30 pm feeding to a before bed feeding time instead. Since you shoot around 6:30 -7:30 am. by feeding at 2:30 that would be +8 to +9 hours after the shot. You usually want to avoid feeding after the nadir (+5 to +7), because there will not be enough insulin left in Jake's system to process the food.

Do you think you could move the that one feeding to a just before bed feeding? More like 9:30 - 10:30 would put it at +3 to +4 after the PM shot and before the nadir. I'd try that and see how it works for Jake.
 
I've changed his schedule to amps 6:30am, feeding ,Shot, small meal at 11am, then nadir test around +5, dinner around 6pm, PMPS at 6:30pm, shot, small meal around 9pm.

His morning numbers are lower. Seems to be working.
 
Glad to hear that making that small change in Jake's feeding schedule seems to be helping to get lower numbers.
 
How many days has he been on this dose?

Are you following the Tight Regulation protocol or the Start Low, Go Slow protocol? Both are linked in the Lantus Tight Regulation forum. Read these over carefully as they explain how to safely adjust the dose and when.
 
Actually, I'm thinking a small reduction.
Why? The pre-shot < 200 suggests he may need less and he's bouncing because he went low overnight.

And it takes up to 3 full days for a bounce to settle, so you might just hold the dose another day.

Any chance you can snag a before bed test, or even set the clock for around his nadir to see if he is going low?
 
Ok, did the +2 test, he was just 2 points below his PMPS number. This AMPS, taken at 6:10 was 127. I'm holding off giving him his shot. Should I give him less?
 
I see you got some advice on the TR forum. It'll be best to stick with posting there unless it is a medical emergency, such as hypoglycemia or high ketones (vet visit for those).
 
I got great advise there! Thanks to everyone here who helped me get Jake down from 6u 2x daily to 2u 2x a day! Hopefully I will be posting OTJ soon!
 
Way to go Jake! Down from 6U to 2U in less than a month! Excellent job there. Hope you can keep dropping that insulin dose down, slowly but gradually and do get to go OTJ, like Wink.

:RAHCAT Go Jake, GO! :RAHCAT
 
Today his numbers were up because I had to give him a can of Hill's M/D today. But now he's back on his Fancy Feast, so I'll do a +2 and see what happens. Hopefully he'll be down tomorrow.
 
Deb & Wink said:
You need to give the dose changes time to take effect and that can be anywhere from 6 to 10 cycles (3-5 days). This is where you need to borrow a pair of patience pants from my vast lending closet and put them on.
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Can I get a pair and a back up pair of those pants, please? lol
 
Don't know your favorite color, so here are a couple of choices for you.



Or how about these, to go along with those "Stinky Pinky" BG numbers Jake was giving you all day yesterday?
 

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