Newbie needing dose advice PLEASE!

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Tracy & Leo

Tracy & Leo

Member Since 2011
Hi there,
I am needing some dosing advice from the Lantus experts. Please take a look at Leo's spreadsheet and let me know if he is on the right dose, and if not, when should i change it? This is day 4 for him being on Lantus. I know he had a bad night last night and had high BG, he was drinking all the water he could and trying to pee in my plants.
 
I am not a dosing expert, and I'm sure one of them will be along soon to help you out, but I do want to point out that this is only Leo's 4th day on Lantus, and it generally takes 5-7 days for the shed to build. I think you need to wait it out a few more days, but let the more experienced folks here chime in. Lantus requires lots and lots patience!
 
Hi & WElcome--Leo had a very nice blue number yesterday, so the dose, while not as effective as you may like, Is Working! Not to worry, for many cats, 1.00U is the starting dose..I am sure a dosing helper will stop by --It is Great that you are testing & doing a curve--Good job!
 
Hello and welcome!!

The first days and weeks can require so much patience. I agree with Anne; the shed needs to fill to see the real impact of this dose, which looks like an appropriate starting point.

Here's what the protocol says (viewtopic.php?f=9&t=1581):
Increasing the dose...

Hold the dose for 3 - 5 days (6 - 10 cycles) if nadirs are less than 200 before increasing the dose.
After 3 consecutive days (6 cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 consecutive days (6 cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Click to expand...
It looks like you should be able to raise the dose, but you'll get some more experienced input before tonight, I'm sure.
 
Hi Tracy, welcome to LL!

As Anne pointed out, Lantus is a depot type insulin, it takes 5-7 days to build the depot (shed). It does require patience...it's too soon to tell if the 1.0u dose will be enough for Leo, you need to give it a few more days. The info Kathy gave you is appropriate to the next stage...when to increase the dose. This is the section of the protocol that applies to where you are now...the starting dose..

"General" Guidelines:

Hold the initial starting dose for 5 - 7 days (10 - 14 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 cycles).
Each subsequent dose is held for a minimum of 3 days (6 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.
Click to expand...

Keep testing and gathering data...you're doing great! The higher numbers you saw last night were likely a bounce in response to the blue number...it is very common, and nothing to be concerned about...the bounce will clear on its own. It can take up to 72 hours for a bounce to clear.

Are you testing for ketones? Does Leo have a history of ketones? If you are not testing, I would get some ketostix and start testing regularly.

I would suggest that you read the stickies at the top of the forum...there is a lot of great info there to help you understand Lantus, the protocol we use, and how this group operates....and please ask any questions you might have. I would also encourage you to post a daily condo, and visit other people's condos and look at their SSs. The people here are very supportive and willing to help.
 
Thank you very much for the information, where can i find the infomation that Kathy and Laurie have quoted me? I'm sure i have probably read it, but i'm on information overload here these last few days, it seems like i spend my whole day reading and reading some more, i think at this point nothing is sinking in anymore.....:(

So everyone is telling me to wait until tomorrow (day 5) at the very least before i change his dose. I just took a +6 reading and it was 286, so if i get around the same range tomorrow and the next day, up the dose to 1.25 U?

As far as i know, the vet didn't mention anything about his ketones, so i'm assuming he didn't have any in his urine. However, i just called the vet and left a message asking if he did test positive for ketones when he was diagnosed, and go from there. I'll add ketostix to my shopping list!

I will look into posting a condo and keep everyone updated.

Thanks for the fast response!

Tracy
 
Hi Tracy and Leo. Welcome to the site sent from heaven!! Gus and I are new to FDMB as well, being diagnosed only a month ago. Your situation (ketones, dose?s, etc) is identical to mine and I'll bet almost everyone else when they first started. You will find that the folks here are far more knowledgable than most vets on the subject of Lantus and everything associated with it. Not only will you get help with all the questions you'll have, but you'll be supported, guided, and encouraged as you go along. Trust the advice and know that the main goal of all the experts here is to help your kitty get well. The learning curve is enormous (understatement of the century) and the amount of info is incredible. You can do it and if you doubt yourself, there is always a reliable group of angels at FDMB to stand by your side. Best of luck to you and Leo!
 
The Stickys at the top of the Page are where you find all the info--Especially the one for new to the group--
Everything you need is there..OK?-Then read all the others--Ask us questions, post ant test numbers you have, and keep calm--All you need is patience & consistancy, and the rest will fall into place--
BTW, Welcome to Lantus land! :mrgreen:
 
Welcome to Lantus Land!!

Sorry that you have to be here but that aside, this is a great place to be. As others have told you, Lantus takes patience. It will take roughly 5 - 7 days for a depot (we call it a shed) to form so that Leo will be able to take advantage of how Lantus works. Right now, a little bit of each dose goes into forming the shed so Leo doesn't get full benefit of the dose.

Congrats on getting home testing down and for getting a spreadsheet up and running. It will also be helpful if you could complete a Profile when you have a chance. The Profile contains information on Leo's health history, what you're feeding, etc. And, BTW, what are you feeding Leo?

As for your question about where the info on dosing was located, it's in the Tight Regulation sticky note at the top of the Board. As a guide to the overwhelming amount of info contained in those notes, here's an outline:

  • Tight Regulation Protocol: This sticky contains the dosing protocol that we use here. There are also links to the more formal versions -- the Tilly Protocol developed by the counterpart of this group in Germany and the Queensland/Rand protocol developed by Jacqui Rand, DVM and published in one of the top vet journals.
  • New to the Group: Everything you wanted to know about this forum and more. Info on our slang, FAQs, links to sites on feline nutrition and to food charts containing carb counts, how to do a curve and the components to look for, important aspects of diabetes such as ketones, DKA, and neuropathy, and most important, info on hypoglycemia.
  • Handling Lantus: how to get the maximum use from your insulin and what to not do with it!
  • Lantus depot/shed: This is an important concept for understanding how Lantus works.
  • Becoming Data Ready: What data you need in order to be able to work toward remission or tight regulation.
Please ask questions. The people here are incredibly generous with their time and information. I hope you'll be posting regularly so we can all see how Leo is progressing.
 
Lantus Land seems like a pretty nice place to be! The people seem very nice, and willing to help me out.

So i've talked to the vet and no Leo did not test positive for ketones, so that's good news! But i did go out and purchase some ketostix......now just to catch him in the act!

Leo was on a dry food diet for the most part before the diagnosis. Since i found out the diagnosis Friday and joined this forum he has been on a wet food diet, mostly Fancy Feast. Today i wrote down all the "good" foods from Janet and Binky's site and bought a wack load of canned food for him to eat. So he's been off dry food since last Friday. I will start a profile just as soon as i get the chance, and thank you for the link.
 
nice work, Tracy!
Leo is a cutie!

and welcome to lantus Land...it is a wonderful place!

you will be amazed at the knowledge and support you'll find here...

celi & binks
 
Tracey and Leo,
Welcome to LL! This is the best place for you to be. My cat, Simon, was diagnosed in November 2010, and I don't know what I would have done without all the people here. You will learn so much and be much better informed when you go to see your vet. Great that you have switched to canned food only. That has made an unbelievable difference not only in Simon, but also in my non-diabetic cat, Cleo. Their fur is much softer, they have more energy and play more. Good luck on the dosing -- it sounds like you have had some great advice from others here.
 
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