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That's a reasonable starting dose. I'm glad he didn't take you back to 0.5u or 1.0u, which sometimes happens. You want to hit the happy medium between not making the dose so high that the cat is immediately in low numbers, and making the dose large enough that the cat isn't sitting in too-high of numbers for too long.

You do want to monitor him frequently. I wouldn't rely on vet testing instead of home testing.

YAY to hear he's holding his weight! That's fantastic!
 
I updated his SS as of 2:30pm today. His AMPS today was the lowest it's ever been since we've been testing him. His mid cycle numbers are higher though.

I was happy to hear about the weight also!

On the SS- sometimes the >500 numbers show up in black, sometimes they don't. Is that an error with the SS somehow?

I'll update his bg with +9 and PMPS this evening. Thanks!
 
The conditional formatting rules aren't correct.
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Hi Alex!

Great job getting the mid-cycle tests in, as well as the preshots! woot! I would encourage you to get at least one pm cycle test - if you test just before you go to bed it will tell a lot. Many cats have their lowest blood sugar at night.

Have you had a chance to look at the Tight Reg Protocol? The gist of it is that people are trying to get their cat's blood sugar into normal numbers (50-120) so that 1) their pancreas can heal if at all possible and/or 2) their organs are protected from damage from high blood sugar. We don't know in advance which cats are able to heal, but we do know that the sooner a newly diagnosed cat becomes regulated the better the chances are for that to happen.

This protocol has us testing a minimum of 3 times a day, most people probably test around 5 times per day, and adjusting the dose every few days to achieve control of their blood sugar. People who are at work all day can still follow it with some creativity - we have single people who work full time that manage to do it. If you are interested, I'd really encourage you to start to post on the Tight Reg Insulin Support Group. There's nothing wrong with continuing to post here, but if you post there, you would have many more experienced Lantus users to keep an eye on you & help you as you move forward.

If you're not interested in that, there is also the option of the Relaxed Lantus group. There is a more comprehensive explanation of the two groups here on the TR Protocol page.

For now, I'd just encourage you to keep on and make sure to get an evening cycle test in. The protocol does suggest:
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).
Click to expand...

If Oz doesn't start getting some regular numbers below 300 by tomorrow evening, you could increase the dose by 0.5u on Tuesday morning.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Click to expand...

The reason the doses are adjusted frequently is to prevent a cat from sitting in higher numbers and having their body get used to those high numbers. Cats will grow to accept high blood sugar as normal and then it takes even more insulin to bring them back down into normal numbers. That's why the protocol suggests holding the dose for 5-7 days EXCEPT if the cat is experiencing high flat curves or is prone to ketones.

Given that it took him 4u of Novolin to just get into the high 100's, it's very likely he's going to need to have his dose increased.
 
Thanks BJM, I got the all the >500 cells black now. It makes it a little easier to compare readings.

Thanks Julie. We'll plan to get a late night test in tonight. I updated Oz's SS with the +9 and PMPS bg readings. We've been getting blood from his left ear because that's the one that bleeds easily (probably because it's the one we've used most often). If we try the right ear it rarely bleeds. I've been using the lancet on the right ear first, then going to the left ear and getting blood for the test. I'm trying to get the right ear to bleed eventually to give his left ear a break. Poor guy really bled at his PMPS. Two drops about the size of a pencil eraser fell on the floor- never had that happen before.

He's not real big on his insulin shots anymore! He tolerates them, but he scoots around when you stand behind him to give him the shot. He started that a couple days ago. In the past he would always stand or sit still.

I almost think I'd be happy with him being under 150. It would be wonderful it we could get him between 50-120, but with us not around all the time during the week, I just hate to risk a hypo episode. Then again, I would think we should be able to avoid a hypo as long as we don't increase his dose by a crazy high amount at one time. I'm kind of confused/undecided!

I would say today was a high, flat curve for Oz. His bg didn't skyrocket then nose dive; it was just high and didn't move more than 150 from the lowest to the highest reading. His lowest bg (+6) was 313 so we probably will increase it .5u to 3.0u on Tuesday morning. The only thing is we won't both be around all day Tuesday to monitor him. The next time we'll both be around all day would be the weekend. But I don't really want him sitting at high numbers all week on 2.5u either. Like I mentioned before, I wouldn't think an increase of .5u when his nadir today was 313 would cause a hypo. I just don't like taking the chance when we're not around to monitor him. Like you said too- 4u of Novolin got him in the high 100's at best, I just tend to worry too much :)
 
I test Gracie on a shelf, tucked under my arm so I can restrain her somewhat.

If your hands are clean when you test, you can snag the drop on a fingernail and test from there. Then pinch the ear between tissue to help the prick clot and reduce bruising and scabbing.

A dab of Neosporin ointment, not cream, applied before testing, then wiped off, helps reduce the annoyance of testing, helps the blood bead up, and helps healing. You can add a 2nd dab after testing to help further with the healing.

What type of syringe are you using? A U-100 3/10 cc (mL) with half unit markings comes in 31 gauge (thinnest) and 30 gauge, plus short and long needle lengths. I like the short needle 30 gauge as I find them less likely to bend.
 
Many people give the shot while the cat is eating. You might try that.

Let's see what tomorrow brings before you increase. :-D

It takes a couple of weeks of poking before the ear grows enough capillaries to bleed consistently. Keep trying and it will improve.
 
BJM- I'll follow your suggestion and try to test Oz tonight alone. His left ear has several scabs on it. I try to vary the spot where I prick him, but so far we can only get blood from a little area on his left ear. We'll keep pricking his right ear each time to get the capillaries to bleed eventually. We're using U-100 3/10 syringes. 29 gauge. 1/2" long.

Julie- We give him the shot when he's eating, but he's on to us now :) I updated his SS with the +3 after the PM shot last night, and also the AMPS and +7 from today. Still high. We heard from our vet today. She said he tested negative for ketones, the fructosamine test came back as 445, and she said to wait until Thursday or Friday and increase the dose "a little" (no specific amount to increase, but I figure .5u). By looking at the bg numbers, do you still think we should increase it Tuesday morning?
 
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