New Member - Dosage Help Please

[Polgeria]

Hi All! Mouse and I could use your help. I was referred over here from the Health and wellness side off my thread there <---see hyper link. Long story short, Mouse isn't stabilizing well on her insulin and I could use a little assistance.

Her vet team is awesome, and is willing to listen to my concerns and work with me, I'd just like to be a little better informed. It looks like I've done a poor job job so far, and made some bad decisions, thankfully not life threatening. I'd like to avoid any further bad decisions before I hurt my baby girl.

 

[Chris & China (GA)]

Mouse isn't stabilizing well on her insulin and I could use a little assistance.

She actually looks like she's doing pretty well!! There are lots of members who would kill for those numbers!!

One thing I can recommend is that you give the same dose both AM and PM. Lantus craves consistency.

She has dropped a little more than I'd like for so early in the cycle tonight so you should plan on getting at least another test in about an hour (+3) You could give her a small snack of low carb food too.

 

[Sienne and Gabby (GA)]

First, Mouse's numbers are by no means awful. From looking at your spreadsheet, there are a few things that may help. Forgive me if I get a bit teachy especially if you've already read the sticky notes at the top of the board.

Lantus is a depot type of insulin. Whenever you give a shot, the insulin forms microcrystals that deposit in the fat tissue. These crystals gradually dissolve which gives Lantus it's duration and allows for overlap between the cycles. That translates to Lantus being an insulin does best with consistency. Shooting differing amounts at AM and PM shot times means that you are constantly disrupting the depot. When you skip a shot, it also disrupts the depot. With this insulin, you always need to consider how the depot is influencing what you're planning.

I'd encourage you to read over the sticky on dosing methods. There are two approaches we use -- Tight Regulation (TR) or Start Low Go Slow (SLGS). If Mouse has any dry food in his diet, you cannot use. TR is more aggressive and has research to support it's use. SLGS was developed here and many people use it. They differ in terms of when you take a dose reduction, when to post and ask for help if you get a lower than expected pre-shot number, how long to hold a dose, etc.

At this point, it doesn't look like you've been following a consistent pattern for your dosing. Using a dosing method and sticking with it will help you to maximize the effectiveness of Lantus and hopefully, get Mouse's numbers where you want them.

As Chris noted, a drop in numbers between your pre-shot test and +2 or +3, can indicate that numbers may continue to drop. I'd suggest getting a +3 test.

 

[Polgeria]

She actually looks like she's doing pretty well!! There are lots of members who would kill for those numbers!!

One thing I can recommend is that you give the same dose both AM and PM. Lantus craves consistency.

She has dropped a little more than I'd like for so early in the cycle tonight so you should plan on getting at least another test in about an hour (+3) You could give her a small snack of low carb food too.

She actually just finished her snack One of the boys tried to open the fridge to get to his food, so she decided it was her turn too. Just so you're aware, those numbers are on the AlphaTrak2 monitor. I heard that makes a difference in your numbers, as most folks use human monitors here.

 

[Sienne and Gabby (GA)]

One more thing, if no one shared this post with you, it provides information about how to structure your signature and provides some other helpful links.

 

[Panic]

In her original thread I said perhaps doing 0.5u for AM/PM would be a good idea instead of 1u/AM and .5u/PM, but I'm by no means a Lantus expert. Anyone have thoughts on that?

 

[Polgeria]

First, Mouse's numbers are by no means awful. From looking at your spreadsheet, there are a few things that may help. Forgive me if I get a bit teachy especially if you've already read the sticky notes at the top of the board.

Lantus is a depot type of insulin. Whenever you give a shot, the insulin forms microcrystals that deposit in the fat tissue. These crystals gradually dissolve which gives Lantus it's duration and allows for overlap between the cycles. That translates to Lantus being an insulin does best with consistency. Shooting differing amounts at AM and PM shot times means that you are constantly disrupting the depot. When you skip a shot, it also disrupts the depot. With this insulin, you always need to consider how the depot is influencing what you're planning.

I'd encourage you to read over the sticky on dosing methods. There are two approaches we use -- Tight Regulation (TR) or Start Low Go Slow (SLGS). If Mouse has any dry food in his diet, you cannot use. TR is more aggressive and has research to support it's use. SLGS was developed here and many people use it. They differ in terms of when you take a dose reduction, when to post and ask for help if you get a lower than expected pre-shot number, how long to hold a dose, etc.

At this point, it doesn't look like you've been following a consistent pattern for your dosing. Using a dosing method and sticking with it will help you to maximize the effectiveness of Lantus and hopefully, get Mouse's numbers where you want them.

As Chris noted, a drop in numbers between your pre-shot test and +2 or +3, can indicate that numbers may continue to drop. I'd suggest getting a +3 test.

Mouse is strictly LC Wet now that she's been diagnosed with diabetes, she was a free feeder on dry food prior to the diagnosis. We had stayed away from wet food due to digestion issues with one of our other cats who has since passed.
If you take a look at the hyper link in my first post, there is an explanation as to why her dose is funky, but the TLDR is that her BG dropped to a point that I wasn't comfortable giving her the insulin, and I wasn't aware that a lower dose was an option. I am aware of that now that I've read through a bunch of the forum posts and will do that in future.

The plan is to do TR, as I think that falls in line with what my vet would like the most. Eventually I'd like to be able to make the decisions on my own about her insulin levels, but I trust my vet's office to help me out, and just want to be informed.