Please help with dosing

I recently lowered Jazz's dose to 1.25 of Lantus because of a couple of hypo events. I haven't dosed her tonight because of where she is now and all day. Any advice? She's not eating much.
https://docs.google.com/spreadsheet...beKHhQ6BIL00z0UuHD0LDGSF9bs/edit?usp=drivesdk

 

You don’t have a dosing method. You are not testing enough at night to know a safe dose. Please skip tonight. You need to at least run a curve every week to see how low his dose is taking him.

On 12/24 a reduction was earned with the lime bg but you didn’t reduce.

 

Hi Terri

I presume you are using a human meter? I see you skipped tonight's shot?

We follow 2 dosing protocols here. If you pick one that will suit you, we can advise you accordingly.
Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)

What is Jazz eating now? If he off the dry food and eating only low carb food?

A small housekeeping note - it would be a big help to us if you can set-up your signature? It's basically a summary of the information we need about your cat to give you advice. The spreadsheet and signature are the things we look at when asked for advice. It saves us asking you the same questions again and again especially when the question is time critical like stalling or low numbers. It also saves you the effort of giving us the information every time you post!

Here's how you can set-up your Signature:

• In the Menu, under your user name, click on Signature.
• Add info we need to help you:
  • Caregiver & kitty's name
  • DX: Date
  • Name of Insulin (do not include dose or frequency)
  • Name of your meter
  • Diet: "LC wet" or "dry food" or "combo"
  • Dosing: TR or SLGS or Custom (if applicable)
  • DKA or other recent health issue (if applicable)
  • Acro, IAA, or Cushings (if applicable)
  • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
• Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
• There is a limit of two lines. You may separate info with commas, dashes, | etc.
• Be sure to click the 'Save Changes' button at the bottom.

Link to previous post:
https://www.felinediabetes.com/FDMB/threads/please-help-hypo-jazz.255195/

 

I don't really know the difference in dosing methods but I do not believe it's tight regulation. I just don't have it on the spreadsheet. I test her all of the time. I'm using a Prodigy meter. Yes a human meter. I'm skipping tonight's dose.

 

SLGS:
You hold a dose for 7 days (unless a reduction is earned). You decrease the dose when the BG falls below 90 mg/dl (on a human meter). The aim of this protocol is to keep the cat in the 90-150 range. This is more suited for caregivers who can't test as much as TR requires. You do a weekly curve with SLGS.

TR:
TR is a more aggressive protocol with increases as often as every 3-5 days. Reductions are earned when the BG falls below 50 mg/dl (on a human meter). The aim is to keep the cat in the range of 50-100 (which is the normal BG range for cats). To follow TR, you would need to get at least one more test per cycle in addition to the pre-shot one i.e. 2 tests per cycle or 4 tests per day. You would also need to be feeding only LC canned food and no dry food.

If you are following SLGS, Jazz earned a reduction by dropping below 90 today. You would go down to 1U from tomorrow.

 

Prior to this sheet she would have a night like 12/24 and I'd reduce and within a week have to go back up again. I test her a lot. No I don't have it on the spreadsheet but I would say we're doing the go slow method. I've been trying to do curves but I'm disabled and am doing the best I can. I thought for once someone here would be happy with the amount of testing I've done since this sheet started.

 

Thank you. Yes I'm going to reduce to one unit of Baslagar starting tomorrow. I guarantee her BG number will be high but I'll assume that's a bounce. She doesn't and never has been interested in dry food.

 

I don't understand why I would've reduced her dose 12/24 when for the next 5 days she was in the 300 -500 range without the reduction.

 

Cats often go lower at night. That’s why it would be helpful to set an alarm for a test between +5-7 at night occasionally.

 

A bg test under 40 is an automatic reduction even with TR. Lantus is dosed based upon how low it takes your cat. When a cat drops too fast or too low they bounce. That’s part of fd. That 38 could have led to a symptomatic hypo. You didn’t test after that and are lucky your cat didn’t end up at the icu on a glucose drip.

 

If you scroll up the sheet above 12/16 you'll see I've done that when I can. I realize cats typically go low at night but I have 5 and all of them eat more at night than during the day. Not sure why. She doesn't eat dry food. She was losing too much weight so I started feeding low carb when she wanted it. She is still underweight.

 

I did test after that I was up all night unfortunately I didn't remember to put it in the spreadsheet. Thank you for your understanding.

 

I agree entirely with everything @tiffmaxee has said…..I was just starting to write the same thing.
You must reduce the dose automatically if it drops under 40. And please if you get a low BG, feed your kitty some high carb food and always test again 20 minutes later to see the BG is rising.

 

Thank you I will work on setting that up as this isn't my first time here. She is on Baslagar and she's not interested in dry food. She's never bothered with it. I do have 5 siblings and her brother enjoys some dry so I switched to Young Again Zero Lid Mature or Wysong Epigen 90. He's healthy with no issues but I switched anyway. I have a CKD kitty as well so it's for her protection too. I appreciate your help and will follow what you've asked me to do.

 

Thank you! Yes I had to use honey at first as she didn't want to eat anything but as the number slowly climbed she then was interested in food. I tested her multiple times it just didn't make it onto the sheet.

 

It is better for her not to eat dry food so that’s good. If underweight feed her as much as she wants.

 

I’m glad you tested her again. Please always try and put all the data in the SS as we look at the Ss every time we help you and all of it is useful and how she responds to carbs after dropping low is important to us.

 

I do. She's very picky and has 5 different kinds to choose from tonight. She's 283 at +7. I did not give her the PMPS dose.

 

She tested 283 +7. I did not dose her at PMPS for the first time since her diagnosis.

 

We really need to see these BGs on a SS, otherwise they don’t make sense.
I going to tag @Bandit's Mom so see if she can help you set up a spreadsheet.
Please answer her message to you.

 

Bron, the SS is set up but not linked in her Signature:
https://docs.google.com/spreadsheet...beKHhQ6BIL00z0UuHD0LDGSF9bs/edit?usp=drivesdk

 

Thanks Bhooma. Terri could you set up the signature and then link the SS to the signature so we can find it please?

 

I attached my SS. Here it is again.
https://docs.google.com/spreadsheet...beKHhQ6BIL00z0UuHD0LDGSF9bs/edit?usp=drivesdk

 

I'm trying

 

I have gone into Signature and followed the instructions

 

I had no problem opening your spreadsheet. Thanks!

I'm curious if you've had a chance to look at the dosing methods for glargine? This is a link to the two dosing methods. They are laid out in more detail than what Bhooma provided.

It does look like Jazz is a bit bouncy. I think having some guidelines for dosing may help to calm down the bouncing. At some points, it looks like you've held the dose longer than necessary and at other times, not taken dose reductions when you needed to. Please take a look at the dosing methods and let us know how we can help.