Newer user Seeking advice

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Knotty dee and Jaxon

Member Since 2012
Hello,

I am seeking advice for my Jaxon. We have been using lantus since Aug 20, 2012 and were increased (not gradually) to 3u. Over the last week Jaxon's number were finally starting to come down. SEE SPREADSHEET, for american numbers

I had a horrible feeling after doing some more reading here that we had been increased too quickly. Jaxon had dropped in to below normal range and I was not comfortable giving him his 3u at evening injection time.
On Oct 1, 2012 i skipped his injection as his BGL was 2.9. the morning after his skipped dose he rose again to 25.1 BGL and i dosed his 3u. he stayed in the low 20's for that day.

Oct 3 he was 17.3 AMPS and 3u given, he gradually dropped down to below normal by +10 hrs at the time of PMPS he was 2.7 bgl and i administered 1u as i wanted to keep his levels from sky rocketing over night as seen previously. before i went to bed he was 4.1 bgl and I left out some we food for overnight.

Oct 4 AMPS 25.6 bgl (so i guess i under shot my dosing the night before) he dropped to high teens at the lowest point that day 3u given at PMPS.

Oct 5 3u in am dropped to below normal at the lowest point of his day. This day i chose to not give his shot at the PMPS time as his level was "normal" when bgl tested +2 of skipped dose i administered 2u at his was in mid teens for bgl.

Oct 6 i made the decision to reduce Jaxon to 2u and make smaller increases as i felt we may have blown past his optimum dose. Jaxon's started out in high teens and dipped to 12 at his lowest 2u given at PMPS

Oct 7 AMPS NORMAL 4.4(BGL) decision to give 1.5u as i could be home with him all day and watch numbers.
+3 AMPS 2.7 (BGL) a snack of 1/3 can fancy feast given at this time.
+4 AMPS 4.9 (BGL)
+7.5 AMPS 3.6 (BGL)
+9.5 AMPS 4.6 (BGL)

I am looking for advice as to his Blood glucose levels. I dont know if i should give Insulin tonight (in 30min) i will likely skip it and test blood 2 hours after he eats and decide then OR do i give him the 1.5u as it has helped to keep his levels steady all day and test him through the night? maybe 1.5 is his "magic" dose???



Please help i really enjoy hearing others opinions.

Thank you!
 
Hello.
Welcome to Lantus Land.
I am guessing your vet increased you in the whole unit increments. They don't think like we do with measurements in between.

It looks like you've been doing a good job getting daytime numbers. You could use more on the pm side, without it , you are missing a lot of data but I thinki you can work on that.

Are you locked in to your shot time?
Or can you stall? Stalling will change your shot time to 12 hrs later from when you do shoot.
It's going to depend a lot on that pmps number.
 
Welcome to Lantus Land, the greatest place you never wanted to be! We're all crazy about our cats and will do whatever we can to help you out. That's great to hear that Jaxon is feeling better and acting like his former, cuddly self. We change dose by no more than 0.25u around here. I am not a dosing expert but Jaxon's dose should at least be reduced to 1.25u based on the 49 (us) that you measured today. Hopefully Sienne or Marje will stop by and give you better advice. How much does Jaxon weigh and how much should he weigh?
Liz, Zener's other mom
 
Hello rhiannon and shadow,

yes i am realizing now that night readings are very important as well. I plan to try and do one tonight.

i am semi locked into shot time meaning that i work 830 am to 430 pm some times later without notice. My husband has not had much success in taking Jaxon's blood sugar (he also doesnt do it very often), he also works various hours and is some times out of town for a few days at a time. i have been giving jaxon his shots at 8am and 8pm. (i also try to come home for an hour everyday for lunch)

yes we were increased in whole units at a time based on a one day curve... vet instructed me to random test and do a 1 day curve after 7-10days after increase.
 
Welcome to Lantus Land.

It's hard to guess where Jaxon's pre-shot number will be. This is the link to what I posted in your thread on Health yesterday.

Lantus likes consistency. When you change your dose based on your pre-shot number, it's unlikely that you are going to get the most benefit from using Lantus. When you base dosing on pre-shot numbers, you are not able to take advantage of the cumulative effect of a long-acting insulin like Lantus.

I'm at a bit of a loss with respect to a dose suggestion. You reduced Jaxon's dose from 3.0 to 2.0 units yesterday after having skipped your PM shot the previous evening. You then lowered his dose this morning to 1.5u. Even with two back to back reductions, Jaxon's nadir was at 49 at AM +3. At the moment, I'm thinking that for safety's sake you should lower Jaxon's dose to 1.25u and hold the dose for the next 3 days unless he drops below 50 again.

I'd want to strongly encourage you to do two things. First, please start getting at least one test during the PM cycle. I mentioned this yesterday and I cannot underscore the importance of getting a test at night enough. Many cats experience lower numbers at night. Without PM tests, you are missing half of your data.

The other suggestion I want to make is that you follow a dosing protocol You can follow either Start Low Go Slow (SLGS) or Tight Regulation. Right now, there's no apparent method to your dosing and I suspect that the lack of consistency is contributing to Jaxon's less than desirable numbers.

Also, you can remove the 911 icon. This isn't a critical emergency.
 
Thank you all for your great input and reading materials. I understand that dosing consistancy is an absolute must and i think that we need to "start over" with his dosing. Where i living in canada i cannot seem to find syringes with 0.25u markings on them, i can only get 0.5u markings. I will be completing a night curve tonight and this will only be able to be completed in sat as i work monday to friday.

My vet has never indicated what Jaxons ideal weight should be. I need to weigh him again at home but at time of insulin starting he was 17.5 pounds down from 22lbs. I must note that he has never been an over weight cat, he is a maine coon so just a big boy, very tall!

I really am trying to sort through all of the info here and make the best possible choices for Jaxon and myself. I may come across as a little confused to be honest because i am..

Thank you all for your time!
 
Wow, Jaxon is a big boy! I don't think there are any syringes with 0.25u markings, just the 0.5u or 1u markings. So you have to estimate where the 1.25u dose is. We use digital calipers from Harbor Freight to try to be as consistent as possible. This whole FD thing is rather overwhelming, especially at first. There is so much to learn. You are at the right place to get the best information. The knowledge, experience and caring in this place are amazing. Just ask your questions and keep asking until you understand.
Liz
 
yes Jaxon is a very big boy, when i adopted him he was 11months and already 14 lbs. He thinks he is a 5lb lap cat and tries his hardest to win everyone over the minute he greets them at the door! we do love him very much!

yes i will be testing every 2 hours throughout the night tonight, is that enough?
 
the more info the better at this point i assume. i feel horrible tho because his ear looks sore, but he only really bleeds from the right ear. I do apply some polysporin ointment to it with every test. anything else that has been helpful?
 
warm ears bleed better than cold ears.
Are you using a sock with rice in it and heating it in the microwave? 15 seconds.

The only other thing is having a lancing device or lancet that isn't really fine gauge. Most everything these days comes with a 31 gauge
lancet which is too fine for the first month of a cat being tested.
 
yes i am heating the sock with rice, i will try again on the left ear but most of the time it has not given me enough to test with. I do have a lancet device that came with our meter and i use it on the 2nd lowest setting. when we started it was dailed all the way up and was going right through his ear. not sure on the gauge of the lancet i will have to look.
 
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