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Vicki

Vicki

Member Since 2015
Hello!
I just started home testing BG last night. It was much easier than I thought it would be. I can't give Elizabeth a pill or liquid meds with any success, but she just sits there for her shots and ear testing. Who woulda thought?

I had been soooo stressed about trying it, but had a good test on my first attempt! Today I have tested 3 x and the first two times had to prick Lizzy's ear numerous times, using multiple strips (Alphatrak2 $$$), but got it perfectly the 3rd time.

If y'all can look at the numbers so far and tell me if you think I did the right thing giving her a smaller dose this morning, I would appreciate it. I will test pre-shot this evening as well, and probably be back here asking for advice.

I do plan on doing a curve, but have to wait to add to my supply of test strips - just ordered them today.

Thanks!
Vicki
 
I'm not quite sure how, but can you check your settings on your spreadsheet? It has to be shared for others to view it. Great job on the testing!
 
Yup, I can see it now! Those are some nice blue numbers you're getting! I won't advise about dose as I'm not familiar with Lantus, but personally I think it was a good idea to lower the dose from 2u. For some great dose advice, you can try posting in the Lantus/Levemir forum. I do know that Lantus likes consistency, so you may want to hold that dose for a week before any increases. But again, you'll get better advice from Lantus users.
 
Hold the dose steady at 0.5 units for a minimum of 3-5 full days, then get nadir period tests (+5 to +7 ) to see how low the glucose goes.
It takes Lantus at least that long to stabilize at a dose.
 
I just tested her and the reading is BG 230. The chart I am looking at recommends the 2u dose. Any advice?
 
You are using Lantus; you keep the dose the same, no matter how high the pre-shot test is.
Pitch the sliding scale as it is for a non-depot insulin.

The starting dose for Lantus may be calculated as follows:
What is your cat's weight?
What is your cat's ideal weight?
Take the lower value (ie, lean weight)
Convert to kilograms (pounds / 2.2)
Multiply by 0.25.
Round down to the nearest 0.25.
That is the starting dose, to be given every 12 hours.
 
Hi @Vicki
Lantus is a depot type insulin. It has the characteristic of being absorbed slowly by the body. The result is an extended action. These insulins tend to display a cumulative effect, meaning that what happens in one cycle can affect the next cycle, or even the next several days. This is part of what allows Lantus and Levemir to create those beautiful, flat curves, so it is worthwhile to spend the time to understand the depot. More information on this can be found here.

I use Lantus with my cat Clyde. @BJM gave you the formula for how to figure out the starting dose for Lantus. The dose should be held for 5-7 days unless the numbers tell you otherwise.

The following is from one of the stickies in the Lantus group on general guidelines with dosing. Please stop by.

There is a ton of knowledge in the folks who frequent that group. Everyone there uses it, is very familiar with how it works, and is more then willing to help you.

"General" Guidelines:
  • Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).
  • Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).
  • Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.

Increasing the dose:
  • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.◦if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
    ◦when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Reducing the dose:
  • If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. See additional notes in the next paragraph about drops into the 20s and 30s. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.
Please do not let yourself become complacent or blasé about drops into the 20s or 30s.
  • If kitty drops into the 20s, a full reduction of 0.25u (or 0.5u if kitty is on a higher dose) is strongly recommended.
  • If your cat drops into the 30s, a full reduction of 0.25u is recommended. There are very few exceptions given for caregivers who have collected years of data and KNOW their cat's response to the combination of insulin and food backwards, forwards, and inside out.
  • Caregivers whose kitties have "High Dose" conditions may find the need to reduce in whole units or more.
    Please ask for advice.
  • If anyone suggests otherwise, they are putting your cat at risk! Our kitties are not just numbers. They are living beings who trust us to look out for them. The TR Protocol is an aggressive method in itself. The modified version of the protocol is slightly more aggressive.
 
Thank you the information - it's all very helpful.

Elizabeth was initially boarded at the vet on 2/16 with numbers in the 400's and started at a dose of 1u, which is appropriate according to the weight calculations. However, the dose was increased to 2u bid on 2/17 and she has been on that since.(she was boarded for 10 days while I was out of town and her initial treatment was started at the vet)

Yesterday morning when I had the 161 BG reading I was nervous about giving her 2u and gave .5u. Now I realize the sliding scale does not pertain to Lantus.

Last night her BG was 230, and I gave her 1u (probably should have been 2u) and this morning her BG is 327. This morning with 327BG I went back to the 2u. This is such a learning process, and I now realize that the type of insulin can make a difference in how it is given and adjusted, and because she is on Lantus I need to keep her at 2u bid for several days and then evaluate.

I will keep reading and considering all the advice you are sending, as well as speaking to the vet. Just to clarify, as I think some have misunderstood - I would never increase her dose without speaking to the vet, and he is being very conservative with increases. I was asking here what the thoughts are on decreasing the dose according to her BG reading. Right now it appears I should have stuck with the 2u bid, which is what I will do and keep home testing.:cat:

Thanks for all the help and encouragement!!! It's very much appreciated!
Vicki
 
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