New Member / Jude's AMPS 159 / Need Advice

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Marielle said:
I'm less sure about what to do, especially in light of your comment about Lantus building up.
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Lantus is a depot style insulin, meaning it takes several days before you see the impact of a dose. Our dosing methods have you hold the initial dose 5-7 days(depending on the blood sugar results and dosing method being used),


If you’re going to follow the SLGS, you hold the same dose for 7 days unless he goes under 90 which means a 1/4 unit reduction

A link that explains Depot Insulin
https://felinediabetes.com/FDMB/threads/what-is-the-insulin-depot.150/
 
Usually when switching to another insulin, we would consider how the previous insulin was working and how low it was taking the cat. Unfortunately while there is some data, it’s not really enough to get a clear picture of what Vetsulin was doing. Starting with 1u of Lantus may be ok if you are going to closely monitor and actually I might go down to 0.5u since we don’t know how low even 1u of Vestulin was taking Jude.

There’s a lot of information shared on this thread, so I don’t want to overwhelm you more than you are likely already, but that would be one key takeaway for you. Please consider testing more often than just the pre shots since you want to be able to see how low the dose is taking him when making dose decisions going forward. Good luck with the switch.
 
Suzanne & Darcy said:
Don’t let the vet have you start with a large dose. Definitely not more than 1 unit, and that only if you can test and monitor the cycle carefully and intervene with carbs if necessary. The reason I say this is because you have already seen some green and blue numbers and now you will be feeding low carb food — is that correct? We always recommend making dietary changes to lower carbs carefully because that really can help to lower BG.

It will take a few days for the depot of Lantus to build up so that you can see how Jude will respond on a particular dose. So don’t be discouraged if you don’t see a lot of action, but it is still best to be cautious about the starting dose and we don’t have a lot of data on Jude’s spreadsheet yet.
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FYI, Jude's AMPS was 175, so I only gave him .5 rather than the whole unit. I checked him again at +3 and he's 146. There is so much information here (which is great), and I'm sorry if I'm overlooking this, but what am I looking for in terms of numbers in a cycle? I know I don't want him to be hypo, of course, so I don't want him to go below 68, but what does the ideal curve look like?

@Diane Tyler's Mom
 
I’m glad you started with the .5 unit. That is what I felt comfortable with, but the vet, I know, recommended 1 unit. Do not increase that dose to one unit. Hold that dose for 7 days and post for advice on next steps. Okay?
 
And I am actually very encouraged by seeing that nice, fairly flat blue cycle today. You do have a little bit of a nadir. It’s an excellent first day on Lantus. Be happy! As the depot of Lantus builds, you will probably see even better numbers. If Jude drops below 68 on your Alpha Trak meter then you reduce to .25 units.
 
Suzanne & Darcy said:
And I am actually very encouraged by seeing that nice, fairly flat blue cycle today. You do have a little bit of a nadir. It’s an excellent first day on Lantus. Be happy! As the depot of Lantus builds, you will probably see even better numbers. If Jude drops below 68 on your Alpha Trak meter then you reduce to .25 units.
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@Suzanne & Darcy
Suzanne, Yesterday, I posted a question regarding ketones in the forum, and Bron and Sheba answered that question, but then she weighed in on Jude's progress and suggested that I reduce his dose to .25 because he dropped below 90 yesterday. He's done that today as well (I didn't get her message to reduce the dose until after I shot Jude this morning, so he received .50.) I just want to run this by you since you had suggested that I maintain the .50 for seven days.
 
Hi! Yes. He is doing really well. If you are following the Start Low Go Slow protocol then reductions are earned when the cat drops below 90.

Have you read the TR and SLGS dosing method sticky note on the Lantus forum?

So with SLGS doses are held for 7 days unless the cat drops below 90, but with TR dose increases can be made more frequently — as frequently as every six cycles (3 days) if necessary. That does not mean that dose changes will be made every 3 days, but only if it is apparent that an increase is necessary then the dose can be increased. Reductions can be taken any time they are needed, of course. It’s early days still, and Jude is doing well! For now, if he were my cat, I would go ahead and take the reduction and see how he does. You may not be seeing the full impact of this dose yet, as he started so recently, so I think, to be safe, it’s better to take the reduction now and then see if he needs and increase later on. If he will do better on TR, you can always switch to that dosing method later. So I say, congratulations on the reduction!

That’s my very long-winded reply to your question! @Bron and Sheba (GA)
 
Suzanne & Darcy said:
Hi! Yes. He is doing really well. If you are following the Start Low Go Slow protocol then reductions are earned when the cat drops below 90.

Have you read the TR and SLGS dosing method sticky note on the Lantus forum?

So with SLGS doses are held for 7 days unless the cat drops below 90, but with TR dose increases can be made more frequently — as frequently as every six cycles (3 days) if necessary. That does not mean that dose changes will be made every 3 days, but only if it is apparent that an increase is necessary then the dose can be increased. Reductions can be taken any time they are needed, of course. It’s early days still, and Jude is doing well! For now, if he were my cat, I would go ahead and take the reduction and see how he does. You may not be seeing the full impact of this dose yet, as he started so recently, so I think, to be safe, it’s better to take the reduction now and then see if he needs and increase later on. If he will do better on TR, you can always switch to that dosing method later. So I say, congratulations on the reduction!

That’s my very long-winded reply to your question! @Bron and Sheba (GA)
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Thank you! I have read the TR and SLGS dosing method sticky, but I need to read it again. I don't know which dosing method to follow (overwhelmed!), so I'm glad someone is guiding me. I will decrease today's PM dosage to .25. I was concerned about how to find that .25 dose on the syringe, but others have offered helpful feedback, and I think I've got that figured out. He did spike up from 80 (@+5) to 169 (@+6.5), but that might have been due to stress--I tested just after driving him home from my work site. Thanks again!
 
You should probably start posting over on the Lantus forums, too. You’re doing a wonderful job with him. Can you try to get a +2 test in at night?
 
Hi Marielle, if you are going to follow SLGS for now I would add that to your signature and your spreadsheet up too so members don't keep asking you :cat: Congrats on the reduction

Just a reminder
When following TR using the Alpha Trak and the BG falls under 68 you reduce

When following SLGS with the Alpha Trak you reduce if the BG falls under 90

If you decide to post on the Lantus forum here is how we do it
In your title you would
Date Jude then AMPS # and any other tests you do after that, then you can continue in your title with PMPS # and any additional tests then tap save.
We like you to post everyday and link your previous days post for continuity.
When you add the additional tests in the title look to the right tap on Thread tools, then tap on Edit Title add the BG numbers and tap save
There are more eyes on the Lantus Forum :cat:
@Marielle
 
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Diane Tyler's Mom said:
Hi Marielle, if you are going to follow SLGS for now I would add that to your signature and your spreadsheet up too so members don't keep asking you :cat: Congrats on the reduction

Just a reminder
When following TR using the Alpha Trak and the BG falls under 68 you reduce

When following SLGS with the Alpha Trak you reduce if the BG falls under 90

If you decide to post on the Lantus forum here is how we do it
In your title you would
Date Jude then AMPS # and any other tests you do after that, then you can continue in your title with PMPS # and any additional tests then tap save.
We like you to post everyday and link your previous days post for continuity.
When you add the additional tests in the title look to the right tap on Thread tools, then tap on Edit Title add the BG numbers and tap save
There are more eyes on the Lantus Forum :cat:
@Marielle
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Okay, I will do the updates you suggested on my SS and signature.

On the Lantus Forum posting, am I posting daily so that folks can oversee my numbers and offer guidance? Also, how do I link my previous day's post?
 
@Marielle
Hi Marielle I stink at explaining things lol
To link your previous post , do you see that cat all the way up top left hand corner , above that in that long line is your previous they call it the URL
It says //felinediabetes.com/FDMB/threads/Jude's AMPS
That is the link you will post to your new post for tomorrow
So tomorrow if you post you will copy that link meaning today's then start your new post for tomorrow and then paste today's link


Or tap on your pic of June then tap on Profile Page then tap on Posts you will see all your posts by the date. You would tap on the previous days post then tap on the long line above, copy and paste it in your new posts
I hope you understand what I mean lol
Yes post everyday so members can follow along and offer guidance
Let me know if you understand lol
 
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Diane Tyler's Mom said:
@Marielle
Hi Marielle I stink at explaining things lol
To link your previous post , do you see that cat all the way up top left hand corner , above that in that long line is your previous they call it the URL
It says //felinediabetes.com/FDMB/threads/Jude's AMPS
That is the link you will post to your new post for tomorrow
So tomorrow if you post you will copy that link meaning today's then start your new post for tomorrow and then paste today's link


Or tap on your pic of June then tap on Profile Page then tap on Posts you will see all your posts by the date. You would tap on the previous days post then tap on the long line above, copy and paste it in your new posts
I hope you understand what I mean lol
Yes post everyday so members can follow along and offer guidance
Click to expand...

Gotcha!
 
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