Newbie advice needed *Updated at +11 w/ question*

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Chicklit

Member Since 2010
Hello Lantus Land. I'm Shellie and my 12 year old cat, Blanco, was diagnosed with diabetes at the end of May. My intro thread is here, if you want the long story: viewtopic.php?f=28&t=15798

The short version: Blanco is on budesonide for severe IBD. He's currently eating DM wet food. My husband was giving him a little DM dry when he seemed hungry, but we've put a stop to that. His appetite is great (the cat's, though my husband's appetite is fine too). He's about 10 pounds.

I feel a bit like a beginner with all of this. My husband and I have read the stickies and discussed them. We've been following the beginner advice to not shoot below 150, though when I've been around to do spot checks and watch for behavior changes, I've shot around or just under 150. My goal thus far has been to get Blanco regulated and avoid a hypo.

After looking at our last curve numbers and our spreadsheet, our vet gave us two options for Blanco: we could go down to 1u of Lantus once a day, or do .5u twice a day. (Technically, I guess he gave us three since he said we could keep doing what we were doing and give 1u when we were able, but since we were missing so many shots due to low numbers, he recommended lowering the dose.) After reading the stickies about how Lantus works, we've opted to go the twice a day, reduced dosage route. We were prepared to see Blanco's numbers in the 200s or even upper 100s this morning and begin implementing the new dose, but Blanco decided to give us a 117 instead.

Since I'm transitioning from beginner to being less of a beginner, I'd like some advice on how low to shoot at given the data we have (or we continue the beginner route until we have better data?) and I'd appreciate some feedback on the numbers. While I get the concept of the typical curve, I'm still not sure what I'm seeing in Blanco especially on days like 6/21. Also, I know I need to start getting some +1, +2, +10, +11 numbers. As I said, I'm just starting out on this journey and looking to learn and most importantly, I just want to do right by my cat.

Thank you very much. I look forward to your responses.
 
Re: Newbie advice needed on chart/doseage

hi there! Glad you made it over.

So - this morning - no shot right?
If you're home, it would be interesting to see what Blanco does.

If you're up for it, try testing at +3, +6 and a +9 to see where he goes without a shot this morning.

Does he have food available to him thru the day or you're there to give snacks?
Try adding a snack around the +9 hour if you're around of course.

Oh and don't feed at least two hours before shot time, or you may see a food influenced preshot number.
We usually see kitties come down after a +9 snack and thats a good sign!

And lastly, if you can, squeeze in a +11, one hour before PMPS time.
Post here for help - that extra hour gives everyone a heads up leading up to the PMPS.


Others will be along to do feedback for you so check in when you can ok?
 
Re: Newbie advice needed on chart/doseage

Hi Ronnie! Thanks for the quick response.

Blanco didn't get a shot this morning. I should be home most of the day, so I'll try to get those numbers and give him a +9 snack.

Blanco's been on 2 meals a day all his life. We don't usually leave food out unless it's leftover from his breakfast or dinner. Since we've switched to all wet, all the time, Blanco eats everything in the morning (and usually tries to steal a little of our civvie's food as well, which is okay since we've moved her to low-carb food as well. We have some mid/high carb wet food on hand for potential hypos. We've also been taking the pre-shot tests before he eats.

The +9 snack is new info for me. I'm willing to give it a try. And I'm sure Blanco will love any decision that involves him getting to eat.
 
Re: Newbie advice needed on chart/doseage

Welcome to Lantus Land Shellie & Blanco!! We usually start the dosing at 1.00U which you already did--Right?
Did you read all the stickies at top of the lantus page?-OK
Here is the typical curve chart--I do amps,+3, +6, pmps & pre-bedtime number--Any other data will be helpful, but you cant be testing all day, every day!--There are many here who can help--Lantus is dfiierent than all other insulins, as it is long lasting, gentle, and works very well--
Here's chart of a typical curve--Hope it helps:
Example of a typical curve:
+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.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.
 
Re: Newbie advice needed on chart/doseage

Hi Roni! Thanks for the info. We actually started at 2u, but switched to 1u pretty quickly. The two days that we've done curves, we've seen something pretty close to typical. Days like 6/21, I wish I had taken more numbers to know exactly what was going on.


I grabbed a +3 just now and I'll continue to edit this post with today's numbers. I have to be out for a couple of hours, but I should still be able to grab a +6 and check in around that time.

AMPS 117 (no shot given)
+3 141
+6 115
 
Re: Newbie advice needed on chart/doseage

Hi and welcome to LantusLand! Blanco seems to be doing really well for 2 skipped shots in a row!. Lantus usually works best when you keep everything very stable. Areserve builds up in the body (the shed) so doses take a while to kick in. conversely, if you skip shots the body draws on the shed andepletes it, so you don' see the effects of that immediately either. I'm not advanced enough to give dosing advice, but especially for newbies it is advised when you do reduce to go down in .25 increments rather than .5 Do you have the syringes w/ half unit markings they are really a help. If you can't get them locally you can order from Hocks, (green link at the top of the page), my orders usually get here in about 5 days and I'm on the other side of the country. Let us know generally where you are, it helps when figuring out time and if there is anyone local that can help personally.

Purina DM is still a 7% carb food and a lot of us keep the carbs down to 1% to 4%. Fancy Feast, Wellness, Merrick and others all have good foods that are considerably lower than the DM. Easier to get too. Check out Janet & Binky's List for the carb % on most canned foods. You need to use the old list for Fancy Feast.

Welcome again! You look to be on the fast track for control of Blanco's FD.
 
Re: Newbie advice needed on chart/doseage

Checking in again.

Ann, after reading all the stickies last night, my husband wanted to go down to .75u instead of straight to .5, so I think we will do that. Thanks for pointing out that Fancy Feast was on the "old" list. I checked it and will grab some Fancy Feast to switch to as the DM runs out. Thanks for responding!

It's been really interesting checking Blanco's numbers throughout today. Because I've only been in Hypo prevention mode so far, I probably wouldn't have tested because he didn't get insulin, but I'm glad I am. At +6 he's at 115. That's a pretty good number, right?

Any thoughts on when we should start giving insulin again? +9 and +11 still to come.
 
Re: Newbie advice needed on chart/doseage

hey +6 is awesome!!!!

Let's see where you're at with the rest of the day. :razz:
 
Re: Newbie advice needed

+9 138 (gave a 1T snack of DM wet)
+11 153

We'll be around tonight, so if this were any other day, I'd shoot. But I'm not sure how much. I'm thinking .75u to see if we can eventually get down to .5u. Do we go back to 1u? This is where the beginner in me gets tripped up. Any advice Lantus Land?
 
Generally, our suggestion is like your vet's -- if you are getting pre-shot numbers that you can't, or don't feel comfortable shooting, then lower the dose so you can shoot consistently twice a day. You could drop the dose to 0.75u. Also, remember that you will not see an immediate change after lowering the dose. There is still a shed that has been built on the basis of 1.0u of Lantus. It will take at least a cycle for the shed to be depleted to your lowered dose.

Let me also clarify -- low numbers are fine and what we look for. Dose reductions are earned with a newly diagnosed cat having a test with a below 50 result. This range is not a symptomatic hypo -- it's a low number. There are very few instances of "hypo" in LL because you are home testing and because we know how to manage low numbers with food. That said, if you are making a trip for low carb Fancy Feast or other food, please pick up some high carb (HC) food, as well. These are the Fancy Feast flavors that have gravy -- grilled or marinated types -- that you will find in the 18% range on Janet and Binky's list. Gravy will bump up numbers very nicely!
 
PMPS is also 153

Thank you for the feedback, Sienne. Husband also agrees, so we're going to shoot .75u tonight. I'm prepared to not see a big change or even to see the numbers go up since we've been skipping the doses, but I feel okay with .75u and shooting twice a day. The skipping doses thing was very worrying, actually, so I'm glad we'll be moving to more consistency.

Thank you, everyone. I really appreciate you helping this newbie out. I feel so much better just talking through some of this. THANK YOU!
 
Hi Shellie, Blanco, and DH (dear husband)! Nothing to add at the moment to the advice you have already received except to say WELCOME to Lantus Land. Post as many questions as you need answers to. And open a "condo" (thread) every day so people can keep track of where you're at and what you're doing. So far you're doing great!

Ella & Stu
 
How about getting a +2 or +3 so you have a sense of how the cycle is going tonight?

There is usually someone hanging around LL pretty close to 24/7. There are fewer people around during work hours (but some of us cruise in when bored at work) and early mornings but if you need help, just put a note in the subject line of your first of post the day. It looks like you've already figured out how to edit the post. If you see numbers that are lower than you're comfortable with, we'll help you to steer them.
 
Last check in of the night. PMPS +2 was at 112. I'm about to take a +4 number and go to bed.

Thanks again for the help and for making me feel so welcome. I admit I was a little nervous about posting here, but you all were so nice to me. Thank you! I'll post a condo tomorrow and try to keep doing them as possible.

'Night all !
 
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