New member, Dallas, 7/14/21

[Dallas boy]

Hello everyone, I'm new to this page and looking for some guidance. My cat was diagnosed in March 2020, went into remission for a year after a food switch but was kicked out of remission approx. 3 months ago. I recently learned that Lantus does not work on a sliding scale, which he has been on for most of the 3 months. I am looking in making a dosing change and stick to one dose. I'm not too sure which dose I should start him on. Would 1.5 units be a good start? If so, what number is too low to give 1.5? I have a spreadsheet, but I'm planning on starting a new one.

Once I start a new consistent dose, I know to get mid cycle checks. I am unfortunaly leaving this weekend for work for 5 weeks so it's a difficult time to change things up, but my boyfriend will be caring for him. Thank you go any guidance you can provide!

His spreadsheet: https://docs.google.com/spreadsheets/d/1sLQq9WRrwLddTbxngYu6VW4xQJutp7aj20CIZMQECA8/edit?usp=sharing

 

[Librarianista]

Welcome! Whatever spreadsheet you use, it would be a good idea to put a link to it in your signature so it's always available to those who are helping to answer your questions.

I am not seasoned enough to give you definitive dosing advice, but it does look like you're changing up the doses too quickly and too severely. Diabetes in cats doesn't work like diabetes in humans where you adjust on a daily basis and with what you're eating. Consistency on your part is the name of the game to keep your cats numbers stable

We generally make changes in .25U increments because cats bodies are much smaller and going from something like 1U to 2U is a 100% increase. The dosages are also based on the lowest point in the cat's cycle (usually +5-7) rather than what they are before you feed/give the shot. Since you don't have many mid-cycle tests, we don't know what the best dose for him has been.

I would check out this post on dosing methods to track your cat's glucose. With your current level of testing, you would be on SLGS: keeping the same dose for a week, doing a full curve (testing every 2 hours for 12 hours), and then evaluating whether that's a good dose or if it needs to change. If you can test more during the day, you can safely adjust the dosage more quickly (every 3 days) to find the right number.

 

[Dallas boy]

Welcome! Whatever spreadsheet you use, it would be a good idea to put a link to it in your signature so it's always available to those who are helping to answer your questions.

I am not seasoned enough to give you definitive dosing advice, but it does look like you're changing up the doses too quickly and too severely. Diabetes in cats doesn't work like diabetes in humans where you adjust on a daily basis and with what you're eating. Consistency on your part is the name of the game to keep your cats numbers stable

We generally make changes in .25U increments because cats bodies are much smaller and going from something like 1U to 2U is a 100% increase. The dosages are also based on the lowest point in the cat's cycle (usually +5-7) rather than what they are before you feed/give the shot. Since you don't have many mid-cycle tests, we don't know what the best dose for him has been.

I would check out this post on dosing methods to track your cat's glucose. With your current level of testing, you would be on SLGS: keeping the same dose for a week, doing a full curve (testing every 2 hours for 12 hours), and then evaluating whether that's a good dose or if it needs to change. If you can test more during the day, you can safely adjust the dosage more quickly (every 3 days) to find the right number.

Thank you for your reply! It won't be possibly to check at +5 or +7 everyday because of work, but we could on the weekends. During the weekdays we can only check at +9 or +10. Hopefully I can get some guidance on what may be a good dose to start him on. he's due for his insulin in 2 hours, and I'm not too sure what to do. I'll also give that post a read. Thank you!

 

[Bron and Sheba (GA)]

Hi and welcome to the forum. I’m sorry no one got back to you sooner.
I’m glad you are setting up one of our Spreadsheets as the one you have often crashes on our computers.
I can see up until recently, you were only checking the BGs at preshot. While that is really good, Lantus is dosed based on the nadir, or lowest point in the cycles, so it is important to get those mid cycle tests in. I understand how hard it can be if you work. A +2 before you go to work is helpful as is the +10 or + 11 if that is all you can manage. The pm cycle is where you can get those extra tests in and at the weekend.

Looking at the SS I think 2units is too much. You need a dose that will let you shoot both cycles without having to skip doses.
I would go back to 1.5 units and stay with that for at least 5 days to let the depot fill unless Dallas drops low in which case you would reduce.
Post here daily for assistance. And change the subject line or start a new post so that the subject line reflects the question.
Have a look at the 2 dosing methods Alex gave you and decide which one would suit you better. I think with being away during the day you may need to start off with the SLGS method. See what you think.
Bron

 

[Dallas boy]

Hi and welcome to the forum. I’m sorry no one got back to you sooner.
I’m glad you are setting up one of our Spreadsheets as the one you have often crashes on our computers.
I can see up until recently, you were only checking the BGs at preshot. While that is really good, Lantus is dosed based on the nadir, or lowest point in the cycles, so it is important to get those mid cycle tests in. I understand how hard it can be if you work. A +2 before you go to work is helpful as is the +10 or + 11 if that is all you can manage. The pm cycle is where you can get those extra tests in and at the weekend.

Looking at the SS I think 2units is too much. You need a dose that will let you shoot both cycles without having to skip doses.
I would go back to 1.5 units and stay with that for at least 5 days to let the depot fill unless Dallas drops low in which case you would reduce.
Post here daily for assistance. And change the subject line or start a new post so that the subject line reflects the question.
Have a look at the 2 dosing methods Alex gave you and decide which one would suit you better. I think with being away during the day you may need to start off with the SLGS method. See what you think.
Bron

Thank you for the welcome! I am definitely getting more mid cycle testing now as I am learning how important those are. It unfortunately won't be possibly to get a +2 on the weekdays as we would have to get up at 4am and change his AMPS:/ but, +8 and on is possible and we can get more mid cycle testing on the weekends. I was able to take more mid cycle testing recently as I've been off work, but am leaving this weekend for 5 weeks.

The new spreadsheet is set up and attached

 

[Bron and Sheba (GA)]

Well done getting the SS up and running. I only suggested the +2 as I thought you might not have left home for work yet. A +8 is good.
Do you have a timed feeder you could use for when you are at work? Having snacks during the first half of all the cycles will help the BG from dropping too much and it’s good for the pancreas to get snacks.
Will your boyfriend be posting on here while you are away? We would be very happy to help him.

Have you decided which dosing method you would like to follow? Looking at the SS and the BGs today I think I would reduce the insulin back to 1,25 units as you will be leaving at the weekend. Is your boyfriend going to test the BGs while you are away?

 

[Dallas boy]

Well done getting the SS up and running. I only suggested the +2 as I thought you might not have left home for work yet. A +8 is good.
Do you have a timed feeder you could use for when you are at work? Having snacks during the first half of all the cycles will help the BG from dropping too much and it’s good for the pancreas to get snacks.
Will your boyfriend be posting on here while you are away? We would be very happy to help him.

Have you decided which dosing method you would like to follow? Looking at the SS and the BGs today I think I would reduce the insulin back to 1,25 units as you will be leaving at the weekend. Is your boyfriend going to test the BGs while you are away?

I do have a timed feeder with iced packs that I can set up for him. He normally gets his breakfast at 6:30am, snack at 12pm, another meal at 6:30pm and one at around 9-9:30pm. I can give him two snacks during the first half of the cycle if you think that would be best.

I will be giving my boyfriend access to my account here and I asked him to reach out here for help. He will be testing while I'm away. Thankfully he's very good at that!

I think I'm going to follow SLGS method. Reducing to 1.25 was the plan. He's due for his shot in 10 minutes and I am assuming it will be below 11.1, so he'll probably get no insulin or a token dose since I don't have enough data on him yet.

 

[Bron and Sheba (GA)]

I think the SLGS method would be better for you at the moment.
If he’s below 11,1 you can stall, don’t feed and test again 20 minutes later to see if it’s rising…. If that won’t throw out your schedule too much or you have to leave for work.
I would give 2 snacks in the first half of each cycle instead of just one.
Great your boyfriend is testing!!

 

[Dallas boy]

I think the SLGS method would be better for you at the moment.
If he’s below 11,1 you can stall, don’t feed and test again 20 minutes later to see if it’s rising…. If that won’t throw out your schedule too much or you have to leave for work.
I would give 2 snacks in the first half of each cycle instead of just one.
Great your boyfriend is testing!!

Oh shoot, it was 6.6 and I already fed him. I didn't give any insulin, but I know it's not the greatest to skip. Would it be OK to give 0.25?

 

[Bron and Sheba (GA)]

Because you don’t have much data on shooting low I think I would skip. Next time the BG is lower, stall don’t feed and see if it rises.