Need help interpreting BG readings and managing insulin dose

AngelaMiao

AngelaMiao

Member Since 2019
Hello!

My cat has been on Lantus just over a week. Originally he was getting 0.75 BID but I moved down to 0.5 because he seemed to be bouncing a lot and going from a new low to a new high.

I'm trying to figure out if his dose is okay or if I should have stayed on 0.75 (or should go lower than the current 0.50). I did a curve yesterday and it was pretty flat the whole 12hrs with no particular Nadir, but his PMPS was much lower than his AMPS and seemed more in tune with the readings I got between the AM dose and the PMPS.

This morning however, he woke up begging for food, had eaten everything I left overnight and drank all the water (usually doesn't drink water unless his numbers are high since I add water to his wet food, so I knew something was up) and when I checked his BG, it was at 445!

Here's his chart!

https://drive.google.com/file/d/11_mM3cxitd-z0DGXA1nKTfz7zuopQ6vV/view?usp=drivesdk
 
You might want to tag one of the people with a lot of experience that can give you dose advice.
Wendy&Neko
Sandy and Black Kitty
or
Bobbie And Bubba

Best of Luck with your Kitty :)
 
Welcome. Please read the yellow stickies at the top of the lantus forum. Dosing would depend upon whether you choose to follow SLGS or TR. if TR, a reduction was not earned. If SLGS any bg under 90 would call for a reduction. Bounces are part of the dance until regulated or remission. My boy bounced for a year! Lower numbers at night are common. We had lots of pj parties. Either way I suspect you need to go back to .75 because even if you choose SLGS it’s a failed reduction in my opinion.

That being said it’s my first time in one of your condos. It’s best to link your condos so that it’s easy to get your history. I’m going to look for your previous ones and will be back.
 
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So if I understand correctly, with SLGS, I would reduce by 0.25 if he goes below 90, but then increase by 0.25 if nadir is over 150 after a week?

I'm a bit confused because on the Facebook forum people were telling me he probably hypo'ed or came close to yesterday night when I wasn't checking based on previous volatility.
 
I think it'll be far less confusing for you if you follow the guidelines here. There might be some key differences in the way FB people view dosing, etc. and trying to follow parts of FB and FDMB will be difficult.

Lots of expertise here on this forum for you. :)
 
Welcome to the Board.

You are correct -- if following SLGS, the dose is immediately reduced by 0.25u when numbers drop below 90 (using a human meter). If nadirs (low point in the cycle) are mostly over 150 for a week, increase the dose.

Sigh.... The Facebook group is not designed to offer any advice regarding dosing. To be honest, the members who post regularly here generally have greater experience. I will occasionally monitor the FB group but it's a pain to wade through all of the posts and there typically isn't a spreadsheet to look at. I will not offer input without a spreadsheet. In addition, some of the people who are offering you advice on FB may not be using Lantus. Lantus is a very different type of insulin than the shorter acting insulins that are available. Many on FB are happy to share their inexperience with you and they don't mind not having a spreadsheet to look at. My personal opinion about the FB group aside, I can't draw any conclusions without data. It's possible that Jack's numbers dropped last night. It's also possible that they didn't.

What I would suggest is that you routinely get a test before you go to bed every night. It looks like Jack, like many cats, has a tendency to see lower numbers at night. We all want to be sure your kitty is in safe numbers overnight. With a PMPS that is in the lower range, making sure that numbers aren't continuing to drop once the food spike from his dinner has worn off is an important piece of information for you to have before you turn in for the night.
 
My bad, I assumed the group was associated since they refer back to this website, uses the same spreadsheet charts and similar protocols.

So let's say I were to use the SLGS approach, should I still wait a bit before going back up to 0.75? I reduced his dose from 0.75 to 0.50 because he went down to 70. Now it's been 6 days that he's on 0.5 and most days, he never goes below 150 (usually much higher), but there has been one day that he went below 90.
 
With SLGS you do a curve after 7 days. If nadir over 150 you increase by .25. So do a curve tomorrow or over the weekend and see.
 
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