New member, need advise on dosage

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@TJP@16 what you have here
New member: Sosa's spreadsheet. Need help with dosage, thank you
Is not your signature
This is what we need

  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Bexacat or Senvelgo (if applicable) and dates
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.


Tap on your name up top, then tap on the word signature and erace what you put and then add what I said above

Do you see mine about Tyler at the end of this post in gray letters
 
TJP@16 said:
Sosa was diagnosed 5 weeks ago. She is on Lantus and gets .50 units 7 am and 7 pm.
I filled out the spreadsheet attached. She was on Fancy Feast but has gone off that so now I have her on Wellness and about a i/4 cup of DM kibble per day. She has the Libre sensor so I use a reader for her numbers. Any help you can give would be appreciated, thank you.
https://docs.google.com/spreadsheets/d/1SH9ygVtdQME7_DFWk2AvsJ_Eu0PTYZK6nDctKvHZy4U/edit?usp=sharing
Click to expand...
@Wendy&Neko
@Bandit's Mom
Hi Ladies Tracy this new member PM me and I gave her the link to post on , just seeing it now. PM me ladt Sat , finally seeing she posted She's from Canada
Just wanted you to know what she said

My cat Sosa who is 12 yrs old was diagnosed with diabetes 5 weeks ago. She was given Lantus 2 units a day. When we got back home the vet increased to 3 u in the morning and 2 at night. Her numbers have been all over the place after joining one of the groups I took her down to .25u because they said she was ballooning but that didn't seem to do anything only keep her numbers high. I changed her dose to .5u this morning and her numbers have come down. I just want to know about dosing and at what numbers are safe to give the dose. My vet said between 3.9 and 9 to give half the dose, if she's above that the full dose. Sometimes with the reader for Lantus the readings will have an arrow straight down. When that happens I get a little anxious because the numbers can come down pretty fast. Any help would be much appreciated.
 
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Tracy, Sosa's mum. 12 yrs old. Lantus. Libre Sensor. Mainly wet food with 1/4 cup of kibble/day. Canada
 
@TJP@16
Tracy I don't think you under stand
We need your signature what you have is not a signature

This is what we need

  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Bexacat or Senvelgo (if applicable) and dates
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.


Tap on your name up top, then tap on the word signature and erace what you put and then add what I said above

Do you see mine about Tyler at the end of this post in gray letters

Tap on your name up top, then tap on the word signature and erase what you put and then add what I said above

Your spreadsheet is not correct
I am going to tag Bhooma one of our members to get in touch with you and help you straighten it out ok

@Bandit's Mom
Please help her with her signature and SS Thanks Bhooma

Tracy what you have which is
New member: Sosa's spreadsheet. Need help with dosage, thank youyou

This is not a signature, Wait until you hear from @Bandit's Mom . her name is Bhooma , she's from India so she will be on later on
Wait until she straightens everything out for you ok
 
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The DM kibble is too high in carbs for a diabetic cat. it's called dietetic management, not diabetic management. Will she eat just wet food? If not, then she likely needs more insulin. If you can get her onto just wet food, the numbers on this dose will improve.

For some reason, the data is not moving over from the World to the US tab, just the colours. I am in Canada, so I "read" world numbers too.

We have a couple dosing methods for Lantus. Since you are feeding dry food, you would follow the Start Low Go Slow (SLGS) dosing method. On this forum and following SLGS, you don't shoot below 11.1 (200) until you have gathered more data. You also want her nadirs, or now points, to be between 5.0 (90) and 8.3 (150). You stay with a dose for a week, unless she goes under 5.0 (90), in which case you'd reduce the dose.

Did you give insulin the night of the 25th? The units is blank, but she came down that night, so I'm assuming you shot insulin that night. If so, you've done 7 cycles or 3.5 days at this dose and need to stick with the dose for the rest of the week.
 
Yes, she had a dose that night, I missed entering it. I was just wondering why her numbers seemed to be getting better but today they've been high for no reason. Also if I do get her between 5 and 8.3 does she still have a dose? Thank you
 
What I suspect you are seeing is a phenomenon we call "bouncing". It's a reaction that causes temporary higher numbers.
Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
 
TJP@16 said:
Also if I do get her between 5 and 8.3 does she still have a dose?
Click to expand...
Keep holding this dose for a total of 7 days. If you continue to see numbers mostly above 8.3 (150) as you have, you would increase the dose to 0.75 units.
 
@TJP@16
Tracy can you please the date Sosa was diagnosed on your signature please which you said is 4-12-24 like you have on your SS

Also can you please read about the 2 dosing methods to follow about Lantus , they will tell you when to increase or decrease the dose
Here is the sticky where you can read about
https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/
After you decide can you also add that to your signature and to your spreadsheet up top .
You have put
Dosing time: 7am - 7 pm that's not correct
It should have said
Dosing Method (SLGS or TR): did you change it to Dosing time yourself?
Can you change it back to read Dosing Method (SLGS or TR) please and after you rear about the 2 dosing methods can you put that on your spreadsheet please
@TJP@16
 
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Bandit's Mom said:
Hi Tracy, you want to start posting in the Lantus/Glargine forum for dosing advice and help with lower numbers etc. It's a more active forum of Lantus users and you should get responses sooner:
https://www.felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/
Click to expand...
@Bandit's Mom
Before she can start posting on the Lantus forum her SS needs to be fixed ,can you help her please, as Wendy said above
For some reason, the data is not moving over from the World to the US tab, just the colours.

@Bandit's Mom
Thanks Bhooma
I sent you a PM on Tues , don't know if you got it :cat:
 
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Diane Tyler's Mom said:
@TJP@16
Tracy can you please the date Sosa was diagnosed on your signature please which you said is 4-12-24 like you have on your SS

Also can you please read about the 2 dosing methods to follow about Lantus , they will tell you when to increase or decrease the dose
Here is the sticky where you can read about
https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/
After you decide can you also add that to your signature and to your spreadsheet up top .
You have put
Dosing time: 7am - 7 pm that's not correct
It should have said
Dosing Method (SLGS or TR): did you change it to Dosing time yourself?
Can you change it back to read Dosing Method (SLGS or TR) please and after you rear about the 2 dosing methods can you put that on your spreadsheet please
@TJP@16
Click to expand...

Yes, I have done that. When you want to add a new conversation it says to add participants?? Who do I know to add??
 
Admin, can you check my spreadsheet and advise on dosing. what numbers should I be looking for and when should I give 1/2 a dose. Sosa was at 12.9 this morning I gave her a full dose but her numbers came down to 4.9 at 10.35am thanks
 
We really need to get your spreadsheet fixed. You should be entering your numbers on the World tab and the spreadsheet should be converting them automatically into US numbers on the US tab. Right now both the US and World are showing just the World numbers...but anyway, to your question:

On SLGS, you should reduce the dose if Sosa drops below 5.0 (90 US) so you should have reduced to 0.25 on May 30 when she dropped to 4.1.

She dropped to 4.9 today, so it's time to take that reduction. Tonight's shot should be 0.25.

TJP@16 said:
what numbers should I be looking for and when should I give 1/2 a dose.
Click to expand...

Lantus works best with a consistent dose so usually we want to give the same dose both AM and PM. If her Pre-shot is under 11.1, you should stall, don't feed and test again in 20-30 minutes to see which way the numbers are going. If they go up without food, that's usually a good indication that the last dose is wearing off and it's OK to give the scheduled dose.

Another thing about Lantus....it doesn't usually start to "kick in" for about 2 hours, so you have to kind of change the way you think because you're shooting the number she'll be in about 2 hours (after she's been fed) which will usually be higher or equal to the PS. If the +2 is lower, that is your "early warning" the she might be dropping more later in the cycle so it'll be important to get more tests in later.
 
We just recently switched her to .50 from .25 because her levels were mainly high. Isn't the goal to get her below 10. If I change it back to .25 unit won't it be the same. I'm very confused with all this dosing. When I took her to the vet this week he wanted me to change it to .75 which I was going to do tomorrow but now I'm not sure. Can you please explain, pre shot number and +2 number should be the same or higher not lower. She gets fed 7am 12pm 6pm 10pm, thank you.
 
TJP@16 said:
Can you please explain, pre shot number and +2 number should be the same or higher not lower. She gets fed 7am 12pm 6pm 10pm, thank you.
Click to expand...

Generally speaking (remembering that every cat is different ECID), with Lantus, it doesn't usually start to "kick in" for about 2 hours and that +2 can act kind of like a crystal ball in predicting where they might be going later in the cycle.

If the +2 is about the same as the Pre-shot, it's usually going to be a pretty normal Lantus cycle...gradually down to nadir, then gradually back up to the next PS.

If the +2 is considerably higher than the PS, that can indicate the kitty is starting a bounce and those cycles you can usually get away without as much testing.

If the +2 is lower than the PS, that's your warning that she may be dropping a lot lower later in the cycle and you should plan on getting more tests in to make sure she stays in safe numbers.

While the goal is to keep them in normal numbers as much as possible (2.8-6.7 on a human meter), it can't be rushed either or you may end up in a hypoglycemic crisis. Just because 0.25 didn't seem to work before doesn't mean it won't work this time. Cats are very complicated creatures and diabetes is a very complicated disease.

Here is some info from the SLGS method: (red highlights are my own)

Hold the dose for at least a week:
  • Unless your cat won’t eat or you suspect hypoglycemia
  • Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
Don't be tempted to rush the process along by increasing the dose more quickly or in larger increments-- no matter how high your cat's blood glucose is! Rushing towards regulation will cost you time in the long run, because you may shoot past the right dose.

Lather, Rinse, and Repeat!

The entire directions can be found in the Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR) Sticky
 
Example of an ACTIVE, but NOT necessarily typical Lantus and glargine biosimilars cycle:
NOTE: Until kitty is pretty well regulated, the description below is NOT not what you'd consider a "typical" Lantus/Basaglar/Semglee cycle. It takes time and patience for kitty to achieve a "typical" cycle! The example below is what you're working towards (a nice shallow curve). A relatively flat cycle is the ultimate goal.

+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number. Onset begins around +2 for most cats. You'll probably see an active cycle if the +2 is the same/similar OR lower than the preshot number. Continue testing!
+3 - Often lower than the PreShot number.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle. NOTE: ECID. Not every cat has a mid-cycle nadir. Adjust the hours on this example to fit your cat.)
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Levemir/Biosimilars: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.
 
Tracy, you test more than enough to do TR. Is there some reason you want to use SLGS? If Sosa is only eating canned food, you could switch to TR which would mean you wouldn't reduce the dose unless she went below 2.8 and you'd only hold the same dose for 6 cycles if the dose wasn't getting the results you want.

You might want to re-read the link I posted above about the 2 different dosing methods used with Lantus. A lot of people choose SLGS because it "sounds" like it is safer somehow, but as long as you can test anytime you need to, it just wastes time and is no safer. TR is also the only protocol that's been published in a veterinary journal so it's not something we just "made up". There's real science behind it.
 
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