Pm+3.5 is 66 on alphatrak help with dosage

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jkluckycharms

jkluckycharms

Member Since 2012
Lucky has been diabetic for over 2 years now and just recently over the past few weeks have been getting lower numbers in the low to mid 100s at pre shot and since the weekend in the 80s did a dose reduction Sunday evening from 3.5u to 3u went back to 100s and now this evening back into the 80s again. He has always been in the 300s so confused about what is happening vet seems to think he is regulating any ideas do I cut back on dose again
 
hello! All I know is that with the alpha trak, 68 is the number that you reduce dose on. With human meters we use 50 as the number to reduce. You should also get another test in 30 min to make sure Lucky doesnt keep dropping to unsafe #s. If he does, we give a couple teaspoons of high carb food to stop the drop and retest every 20-30 min til you get 2 rising numbers without food. Im thinking that he earned a reduction in dose with that 66.
 
+4 was 60 he has been nibbling on fancy feast classics mixed grill that is all he will eat or he throws up I do have karo here if needed. Will check again at +4.5
 
ok..just dont feed too much..you dont want to fill him up too quick in case you have to keep giving food to get the numbers above 68 and and ideally up into the 80s. Most cats on lantus(he is on lantus correct?) will nadir, or go lowest at +6, so if you know the nadir is +6 then he will have a couple more hours til he reaches peak, so be ready. I know those strips are pricey!! but you need to make sure you test every 20-30 min. You want to give a small amount of food, a teaspoon, and test again until he is above 68.You will have to repeat these steps until you see 2 rising #s without food.
 
Normally we reduce by .25u. I usually dont give dose advice, but looking at the spreadsheet and how his #s are looking, I think you could reduce to 2.5. Seeing that he dropped to 60 tonight, you dont want a repeat of that, especially if you cant test more often than you have been. If you start seeing higher #s for a few days, then you can increase .25 to 2.75. Right now its more important to keep him safe. And dont be surprised if you see him bounce up high after these low #s, but he will eventually settle in to the reduced dose and you go from there. If you get another rising number and you havent fed him since the last test, he should be ok for the night. Would like to see him in the 80s before you call it a night.
 
Hi there,

For some reason, I keep losing the answers I sent. Look for a PM from me.

Let's see if this posts.

Claudia
 
Oh my! Well, first off, your spreadsheet confuses me a great deal, I am not sure why you started testing only every couple of weeks, but I am sure glad you happened to catch this low and be able to manage it!

Now, as for dose moving forward. If this was my cat, and given the low today and the lack of data as to what has been happening the last week or so, I would immediately drop this cat down to 1 unit. I think you need to 'reset" and see where he really is at nadir. Those low numbers for the last 3 days are trying to tell you his pancreas is reviving. I would advise that you drop to 1 unit, test for ketones religiously, get preshot, +2 and +6 tests at the very least, and then lets see how he does.

Lets see what others weigh in with. What does kitty eat?
 
Thanks for your replies. Lucky has just tested at 64 and he just ate some more. He eats fancy feast classics chopped grill only he refuses everything else. For the past 2 years he has not shown the least bit if coming out of the 300s until recently so I was just spot checking for his levels. He was on 3u of lantus at the time of his lows today which is actually a reduction from Sunday when he was on 3.5u. I have been working with our vet who is also getting consults from a specialist in feline diabetes that she met at a conference and I talked to her Monday but will call again tomorrow with the latest update. We figured the 300s were normal to him cause he just wouldn't come out of them but I guess he has decided to surprise us.
 
Hi again,

Since my quick message finally posted, I'll try again.

Like Linda, my recommendation is to drop Lucky's dose to 1 unit in the morning. His numbers have been low for a bit. He may bounce around for a few days with the lower dose. I would try to hold the 1 unit dose for a few days UNLESS he DROPS again. If he drops again, you might try an OTJ trial and stop the insulin.

Lucky may have remission in his future. If he continues to be under 120, I would consider the OTJ trial.

All the best,

Claudia
 
I completely agree with Claudia. What I can make out of Lucky's spreadsheet he's had multiple dosing changes that where based on preshots only which isn't the way to dose with a depot insulin like Lantus where dosing changes are based off the lowest point in the cycle.

My Cassanova was up to 11u bid before I adopted him because no one was home testing him yet within 6 months of daily multiple tests I've lowered his dose to .5u bid.

If Lucky was mine I'd drop back to 1u bid hold for a good 7-10 days and test as much as humanly possible. Both preshots, a mid cycle around +6 and a before test at minimum.

Mel and The Fur Gang
 
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