Oliver numbers reading and dosing help

Melody I.

Melody I.

Member Since 2019
Hello and Happy New Years Eve! Oliver was diagnosed with diabetes the day before Thanksgiving. He had a BG of 386. The vet told me to give him 3 units of glargine 2x day. I am using Basaglar and when I started home testing him I immediately dropped his dosage as the 3 units was taking him too low. Since then I have been adjusting his insulin for every shot but after discovering this site I see that probably isn't the correct thing to do. I've got about a month's worth of data in Oliver's spreadsheet and I'm not seeing any trends, which is probably due to constantly adjusting his dose. I'm off of work for a couple of days so will do more mid cycle testing. Would the recommendation at this point be to just start over with a lower dose and be consistent with that for a week before changing dosage? My vet doesn't seem to be FD knowledgeable and keeps wanting me to bring him in for all day testing, even though I'd doing the home testing. Any help or advice would be appreciated.
 
Welcome to the FDMB. I’m glad you found us. Congrats to you for home testing and catching that your starting dose was too high. You are correct that your vet is not up on this which is way too common with vets. Please read the sticky on Lantus and the methods used here. I’d hold the dose at l unit to see where it takes Oliver. Lantus likes consistency so switching around the dose doesn’t allow the depot to build.

If you decide to follow SLGS a reduction was earned since he fell under 90. With TR the reduction number is under 50.

You can do your own curve at home. The numbers at your vet’s office will likely be inflated due to the stress of being there. It’s a money maker for the vet unless you aren’t able or willing to test at home. I used to send my spreadsheet to my vet every few weeks. The only curve he ever did was after the first shot of Lantus and he was fine with that. Actually I never did a curve either as I tested a lot at different times so it wasn’t necessary.

You will get all the help you need here and hopefully reach remission.
 
Welcome to you and Oliver!

I'm so glad you were home testing and reduced Oliver's dose. That was a huge starting dose of Basaglar.

This post on Helping Us to Help You will be a way to get started and make sure you have supplies and some basic concepts in place. There's also information on what to include in your signature so we know a bit more about Oliver and have some of the important information, in addition to your spreadsheet, easily accessible.

It is hard to know just what's going on with Oliver due to the frequent adjustments to his dose. One helpful item to keep in mind is that Lantus dosing is based on the lowest number in the cycle (the nadir) and not on the pre-shot numbers. The pre-shot numbers help you to know if it's safe to give insulin. The nadir tells you how low the dose is taking the numbers. Thus, it's important to get some spot checks during both the AM and PM cycles like you've been doing the past couple of days.

I'd encourage you to look over the sticky on dosing methods. The two approaches are what we follow here and it's helpful if you can make a choice so we'll know how to best advise you. Please let us know if you need more information about either method.
 
Thanks for the welcome and the replies. I've been spending some time reading and trying to absorb all of the helpful information contained in the various forums and by reading other posts and replies. There is so much to learn! Before posting here I had been basing his dose on his pre shot numbers and not his nadir. I'll hold steady at 1 unit now and will hopefully be able to truly determine how he is reacting to his insulin and at what times. As much as I would love to go with the TR method I must admit it scares me but maybe once I have more consistency in his dosing and understanding his numbers and cycles I will switch over. For now I'll try the SLGS method while continuing to learn from others.
 
Changing from one dosing method to another is fine. People do it all the time.

A housekeeping note given your decision. If you could add that you're using SLGS to your spreadsheet. At the top of the sheet in the orange box you can specify whether you're. using TR or SLGS. Just note that you're using SLGS.

Also, if you want to tag someone, especially if you're replying to a question, if you type the "@" sign and start to type their user name, a drop down will appear and you can then click on the name. You'll then have left an alert for them so they can then come directly to your thread. I've done this to let you know I responded to. your post. The Alert is at the top right of of the page. @Melody I.
 
Welcome to the best place you never wanted to be!

Yes, there's a lot of information to absorb - it's almost overwhelming - but just take it one day at a time - read a little more each day and you'll get it!

Oliver is gorgeous btw! Love the avatar!

I'm so glad you've found the FDMB! It's a lifesaving group of kind folks here :)
 
After a week of holding Oliver's dose at 1 unit I reduced his dose down to 3/4 of a unit as his mid point reading at one point was 67. His readings have been all over the board and he has had his highest reading ever at 447. Do I hold the course at 3/4 or do I move him back up to 1 unit? He had a little bit of up and down at 1 unit but nothing like he has seen the last couple of days. Are these wild fluctuations in numbers causing him harm? Should I be starting a new thread with these replies or is it more helpful to reply to the existing so the conversation history is available?
 
Hi :)
So, that reduction after the (67) was appropriate as you reduce for anything below (90) with SLGS. With the (96) @ +5 , I might check another BG just to make sure Oliver doesn't go lower closer to +6 or +7.
If so, he would earn another reduction. If the (96) is as low as you see - you would hold this dose until it has been a week, do a BG curve as reassess based on how low this dose (0.75) is taking him.
What is he feeding schedule as night? Do you offer snacks or meals overnight ?
I feed my guy another meal at midnight/ +5 plus a snack at +3 and +8 just to help him stay level overnight. I found that the +8 snack helped to lower my AMPS numbers, but if a kitty is bouncing up high from a low number - they are just gonna bounce.

As for posting, the like for you to post 1x per day. You can post a link to the post for the previous day in the new post for clarity. In the title section you would label it like this :
1/7 Oliver AMPS (447), PMPS (112), +5 (96) - so folks can see the BG range for the day so far. :)

Just for reference: SLGS

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
 
Dumb question, how do I create a link to this prior posting thread that I can paste into a new thread?
 
I haven't been giving Oliver snacks between meals. Sometimes he doesn't eat all of his meal in one sitting so it is there to nibble on and sometimes it's gone pretty quick. I have another non-diabetic cat who is supposed to be on a diet so I'm trying to monitor food intake and I have a feeling that if I put food in a timer for Oliver he wouldn't get it before his pesky little brother does.
 
Melody I. said:
Dumb question, how do I create a link to this prior posting thread that I can paste into a new thread?
Click to expand...

I just copy and paste, but you can copy and hit the link button in the row where the Bold, Italic, underline options are above where you type...it looks like a chain link symbol. That will pop open an option tab for you to create a link. This is also how you can create a link for the SS - like yours says Oliver's SS.
 
Melody I. said:
I haven't been giving Oliver snacks between meals. Sometimes he doesn't eat all of his meal in one sitting so it is there to nibble on and sometimes it's gone pretty quick. I have another non-diabetic cat who is supposed to be on a diet so I'm trying to monitor food intake and I have a feeling that if I put food in a timer for Oliver he wouldn't get it before his pesky little brother does.
Click to expand...

Sometimes smaller more frequent meals can help heavier cats lose weight actually...similar to how they tell people to eat 5-6 smaller meals / day. Metabolically, I think the intermittent fasting can cause cats to gain fat, burn up muscle but ECID.

I just cut down the amount of food I was offering my cat and broke it into 3 meals / 12 hours with a snack after every meal.
 
My vet has told me that small meals more often is better for pancreatitis and it worked for Max. It also helped regulate him when he became diabetic. I just tried to feed most of his food in the first half of the cycle.
 
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