Princess at 204 preshot this morning

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Princess mother

Princess mother

Member Since 2015
For the second day in a row Princess had a big drop in BG. Tonite it was 80 3 hours after 1 unit of lantus. should I be worried?
 
Hi there :cool:

Love the pic of Princess!

I encourage you to read (and re-read) the informational "sticky" posts at the top of this forum. Lot's of important information there regarding the nuances of using Lantus to safely work toward regulation or remission.

A couple things popped out at me-
I see a change of food recently noted on the ss - has she transitioned from dry to 100% low carb wet?
If so that right there could result in lower BGs and therefore require a lower dose.

I also see a different dose each of the last 4 cycles. Lantus works best when you find a dose that you can shoot consistently.

Are you able to do more monitoring?
 
Hi Marie!!

Just a quick housekeeping note...Here in this forum we only post one new "condo" per day. As the day goes on, you can edit the subject line to say what you need it to say. Here's your earlier condo from 2/26

The 2 units was probably too high a dose for Princess to begin with, and now that you've gotten the dry out of the picture, her insulin needs are dropping too. Due to the fact that she was on 2 units for awhile though, even though you've dropped the dose, her "depot" is probably still effecting her numbers. Lantus is a "depot" insulin so when you shoot, not all that dose goes to work during that cycle...part starts to work and the rest goes "in the depot" (stored in the body and slowly released which is why Lantus works so well) Her depot is probably just over-full right now

Now that you're on only low carb wet and starting to see some much better numbers, I'd probably stay at 1 unit and hold that dose for at least 6 cycles (Unless she drops below 50) and see how she looks then.

You're doing a pretty good job of getting tests in now too. Can you get mid-cycle tests like you did today most of the time or only some times?
 
If you see a drop into the greens like that, it's always good to get another test before going to bed. You want her numbers to be stable or going up before calling it a night. If you can't stay up, then leave out lots of food for her to munch on so she can bring herself up if she needs to.
 
Chris & China said:
Hi Marie!!

Just a quick housekeeping note...Here in this forum we only post one new "condo" per day. As the day goes on, you can edit the subject line to say what you need it to say. Here's your earlier condo from 2/26

The 2 units was probably too high a dose for Princess to begin with, and now that you've gotten the dry out of the picture, her insulin needs are dropping too. Due to the fact that she was on 2 units for awhile though, even though you've dropped the dose, her "depot" is probably still effecting her numbers. Lantus is a "depot" insulin so when you shoot, not all that dose goes to work during that cycle...part starts to work and the rest goes "in the depot" (stored in the body and slowly released which is why Lantus works so well) Her depot is probably just over-full right now

Now that you're on only low carb wet and starting to see some much better numbers, I'd probably stay at 1 unit and hold that dose for at least 6 cycles (Unless she drops below 50) and see how she looks then.

You're doing a pretty good job of getting tests in now too. Can you get mid-cycle tests like you did today most of the time or only some times?
Click to expand...
Hi Chris,
Thank you. I didn't know about the "condo" protocol. Good to know I can change the subject line in case I need help. I also didn't know about the depot. Don't think my vet knows either. She also lost a 1/2 pound since taking her off the dry food. I think that may have contributed to the need for less insulin as well. I'm going to try in the next few days that I am home to get more mid cycle numbers. Do you suggest any best times? She getting wary of the pinch!!
Marie
 
Sandy and Black Kitty said:
Hi there :cool:

Love the pic of Princess!

I encourage you to read (and re-read) the informational "sticky" posts at the top of this forum. Lot's of important information there regarding the nuances of using Lantus to safely work toward regulation or remission.

A couple things popped out at me-
I see a change of food recently noted on the ss - has she transitioned from dry to 100% low carb wet?
If so that right there could result in lower BGs and therefore require a lower dose.

I also see a different dose each of the last 4 cycles. Lantus works best when you find a dose that you can shoot consistently.

Are you able to do more monitoring?
Click to expand...
That picture is of her staring at me waiting for food!! I get that look most of the day! Yes, she is completely transitioned to wet food although she still cries for the dry. Anytime a bag of anything is opened she comes running. Its like kitty crack! The reason for the 4 doses is the vet instructed to give her different doses for different readings....I'm going to stick at 1 unit for now unless she plummets below 50 as suggested above. Going to try to get more numbers today but it is hard because she has only one good ear that is giving me blood. She lost half of the other before I took her in as a tray.
 
Lantus likes consistency so giving the same dose each day is better unless she is low or goes low.

I used to test &feed like this:

Preshot test, feed and give insulin
+2 hours test and feed again
+4 hours test and feed again

Then depending on previous numbers just feed again and +5 or +6 or maybe get another test in. I used to give he shots at 6am and 6 pm to enable me to get these tests in. Others don't test as much or tested at other times. Blood glucose is affected for approx 2 hours post feeding hence the times I decided to test and feed.

Link on the depot
http://www.felinediabetes.com/FDMB/threads/lantus-levemir-what-is-the-insulin-depot.150/
 
let's see where she is in 90 minutes at your shot time.

Unless she goes below 50 now, I wouldn't give her any more food at this point. We usually like to see 2 hours before the shot not having any food, unless you have to feed in order to pull up low numbers (under 50). You want that preshot number to be free of being influenced by carbs, in other words, you don't want to test after you've fed and see a higher number (spike in blood sugar from the food carbs) and think she's high enough to shoot if she's really not. Food spikes can drop in a half hour or hour.

Can you repost at your shot time and put in the subject line "should I shoot now?" so people know you need help asap.
 
Would you go ahead and take off the 911 if you're ok now? If you need it again, pop it back up, but at whatever point you think you're ok, it's good to take it down.

Since she's around 50, you want to test at least every 30 minutes. How is she now?
 
julie & punkin (ga) said:
Would you go ahead and take off the 911 if you're ok now? If you need it again, pop it back up, but at whatever point you think you're ok, it's good to take it down.

Since she's around 50, you want to test at least every 30 minutes. How is she now?
Click to expand...

She's looking and acting fine. I'll retest in a few minutes.
 
Just to clarify, are you following the Tight Regulation Protocol? If so, I wanted to give you the information from the "Shooting & Handling Low Numbers" sticky now, so you have a chance to look at it before +12. See if it makes sense, and if you have any questions, just holler.

If you're following the Start Low Go Slow, you would decrease the dose based upon going under 90 today.

I had a 32 with Punkin one time and he was acting fine - trust your glucometer! :D



HOW TO DEAL WITH LOW PRESHOT NUMBERS
**** The following guidelines apply to the Tight Regulation Protocol for Lantus or Levemir ****

You just tested your cat’s preshot number, and there is a much lower than usual number staring back at you. What do you do?

There is no one-size-fits all answer, but there are some general guidelines. As with everything else, each cat is different (ECID) and each caregiver is different too.

The short answer is that most kitties can be shot at +12, almost regardless of the number, once you are data ready to do so. The exception is that shooting 30s or 40s is not recommended for most cats, so if the cat is less than 50 then usually the best option is to wait until they are above 50 to shoot. While you’re waiting, the shed is draining, so you want to get the insulin in as soon as it makes sense to shoot.

If it is your first time shooting green, then we will likely suggest that you stall the first time, even if the number is 80-100. That will let you collect data on what your cat will do when you stall. One thing you can do if you are having a low cycle is to get a +10 and +11. Those will give you a good idea of how quickly the cat’s numbers are rising (or not) when preshot time arrives.

Beyond the general guidelines, there are other factors we consider when we are helping someone with a low preshot.
  • If the low preshot is not part of that cat’s normal pattern or there is reason to think something might be wrong, we will be more conservative.
  • If the cat is not a food spiker or tends to have an early onset/early nadir then they may not want to shoot as low. If the cat has a late nadir, then they will HAVE to learn to shoot low.
  • We will also be more conservative in some cases because of the person – if you are not able to monitor then you want to be more careful, or if you are not sure that you can get back to the board to keep us updated throughout the cycle. Trust me, if you shoot low, we will be watching for your updates and we will worry if we don’t see them.
  • We have to be a lot more careful with the cats who eat only dry food, because they don’t have access to the tools the rest of us use to keep our cats safe.
  • Also, when it comes to very low preshots, there is an unwritten rule that whoever helps that person shoot low should expect to sit with them through any low parts of the cycle. There have been times when I knew a cat’s number was likely shootable, but I also knew that I could not be around to help if the shot resulted in low numbers later in the cycle. For safety’s sake, if I could not find someone else who would be available to support for the next several hours, I would most likely suggest that the shot be reduced or skipped. I will not encourage someone to shoot low and then abandon them.
  • There are a lot of other scenarios, and you always want to keep your cat in mind.

Some general rules when stalling (ECID):

** 50s or higher – don’t feed. The number will bump up on its own soon due to the insulin wearing off.
** 40s or lower – you have a couple of choices.

  • When 40’s occur at the end of the cycle, it can be beneficial to withhold food and test in 15-20 minutes to determine if kitty is on the rise or hasn’t reached nadir yet.
  • If they are hanging in the 40s for a while, or if they are still dropping, it is ok to feed a tsp or two of LC and retest. This is very tricky. You want to avoid feeding too much while you’re waiting for them to go over 50, because you don’t want to artificially inflate the number with food.
  • --- Example: if kitty is 43 and you feed a whole meal, or feed some HC, and the number bumps up to 52, is that the cat’s natural end-of-cycle rise, or is it food spike? What if it is food spike? Then if you shoot the 52, when the food wears off he might drop back to the 40’s (and when insulin kicks in a couple of hours later, you might have a problem). If the 52 is the cat’s natural rise, then he will probably keep rising for the next few hours until insulin kicks in. If you can’t tell whether the number is food spike or natural rise, it’s safest to wait. Your data will help you here. Study the spreadsheet. How much food spike does the cat usually get? How many hours after the shot does the insulin’s onset usually occur in this cat? At what number is the cat likely to be when onset occurs? If the cat does drop, how easy/hard is it to regain control of the numbers? How carb sensitive is he?

** Test often (every 15-20 minutes, or at most every 30 minutes). You want to catch the rise the minute it starts. With most of our cats, once they start to rise they will really zoom. You want to get the insulin in as soon as possible, because it will be another 2-3 hours before the insulin kicks in and you don’t want to let the cycle get too far ahead of you.

Perhaps the most important guideline in shooting low is that any time you shoot your lowest ever number, you should get a +1 and +2 to give you an idea of how the cycle will go. If the +1 is not higher than PS, or if +2 is much lower than PS, that means “pay attention” over the next few hours. Those tests will also help you become even more data ready for the next time you are presented with a low preshot reading.

Using the overlap by shooting low is a great way to take advantage of Lantus/Levemir’s long, flat cycles, once you have learned to do so safely.

~ written by Libby and Lucy​
 
thanks for taking off the 911 - i think you'll want to just remove the post icon? the GA means "gone ahead" or that the kitty has passed away.

sorry there are so many little things on this forum - don't let them bother you!!! i just don't want people to think Princess has died!
 
@Princess mother

It looks like you accidentally changed your icon to GA....that is used when your kitty has gone to the Rainbow Bridge. I sure hope that is not what happened, but you may want to try to change that one more time
 
perfect! You may have no issue at all at pmps after all! it's probably the normal end-of-the-cycle rise that Lantus often has.

I just want to say WAHOO, though, because she spent HOURS today in green numbers. That's fantastic - everything in the 50-120 range on a human glucometer is the range that the pancreas has the opportunity to heal in. People work hard to get their cats in that range, and Princess gave it to you today!

You've shot as low as 79 already. If for some reason you have the opportunity to shoot lower than that, we always suggest people get a +1 and a +2 just so they have no surprises about where the kitty is headed.
 
julie & punkin (ga) said:
perfect! You may have no issue at all at pmps after all! it's probably the normal end-of-the-cycle rise that Lantus often has.

I just want to say WAHOO, though, because she spent HOURS today in green numbers. That's fantastic - everything in the 50-120 range on a human glucometer is the range that the pancreas has the opportunity to heal in. People work hard to get their cats in that range, and Princess gave it to you today!

You've shot as low as 79 already. If for some reason you have the opportunity to shoot lower than that, we always suggest people get a +1 and a +2 just so they have no surprises about where the kitty is headed.
Click to expand...
Thanks, Julie. I realize I shouldn't have panicked and given her food right away. So that might be a food bump. Did I screw up?

She did spend a lot of time in the "green" today. I'm using an Alphatrak 2 whose strips are very expensive. Is there a human glucometer I could use.

Marie
 
no - you didn't screw up. it was fine - and actually since that's an AT she did earn a reduction. AT reductions happen at 68AT. So your new dose would be 0.75u.

Yes, those AT strips are expensive. You can use any human glucometer - although the ones with True in the name have not been rated well by Consumer Reports, and the Freestyle measures blood differently. We started with one and the ss with a Freestyle is typically all blue and yellow.

Most people buy a Relion at Walmart or an Arkray from www.AmericanDiabetesWholesale.com. You can get generic strips at ADW that work in the Relions. I used a Confirm - but there are newer glucometers and I'm not current on the latest info. If you put something in your subject line it'll draw the people with the latest info - something like "choosing new glucometer?" You can get human glucometer test strips for at least 1/4 the price of AT ones - so 4 tests on the human meter would cost about the same as one AT. I know some people have it down to an art and I've even seen people say they had test strips for 10 cents each. So you might as well get advice before you move ahead.

By the way, if you do buy from ADW (above) you can register first at www.mrrebates.com and get a rebate back on everything you buy at ADW.
 
oh - and would you put "AlphaTrak2" in your signature line, along with which protocol/method you're using, please? it helps those of us helping you.
 
I use the ReliOn Micro....the strips are a little more expensive than the Prime (I think it is), but I now get his strips from ADW, so I can usually get a deal on them :)

Two things I like about the micro.... 1. it takes a smaller amount of blood to test, and even after a year, I have issues sometimes getting enough blood and 2. In some meters you have to take the strip out and put it back in to "reset" it if you don't get the blood on there fast enough, not an issue with the micro....

I got it for about $16 at Walmart.....at Walmart the test strips are $35.88 for a pack of 100...again, I do buy them from ADW now and get a better deal on it.... I was not aware of the rebate thing @julie & punkin (ga) so I will be doing that right away :)
 
julie & punkin (ga) said:
oh - and would you put "AlphaTrak2" in your signature line, along with which protocol/method you're using, please? it helps those of us helping you.
Click to expand...
I will thank you. I don't know which protocol I am using. The vet's office has been no help. One said 1 unit when below 300, 11/2 when above. Another said 2 units no matter what. Both said no BG testing. As you can see, I'm doing this my way and have gotten my info and help from the forum. I will reread the two protocols and post later.

I have another question....I have to go on an overnite business trip Thursday returning Friday after 10 pm. I will miss 3 shots. The person who is going to watch her can do the shots but not the BG testing. I cant get out of this trip. What do you suggest?
 
julie & punkin (ga) said:
no - you didn't screw up. it was fine - and actually since that's an AT she did earn a reduction. AT reductions happen at 68AT. So your new dose would be 0.75u.

Yes, those AT strips are expensive. You can use any human glucometer - although the ones with True in the name have not been rated well by Consumer Reports, and the Freestyle measures blood differently. We started with one and the ss with a Freestyle is typically all blue and yellow.

Most people buy a Relion at Walmart or an Arkray from www.AmericanDiabetesWholesale.com. You can get generic strips at ADW that work in the Relions. I used a Confirm - but there are newer glucometers and I'm not current on the latest info. If you put something in your subject line it'll draw the people with the latest info - something like "choosing new glucometer?" You can get human glucometer test strips for at least 1/4 the price of AT ones - so 4 tests on the human meter would cost about the same as one AT. I know some people have it down to an art and I've even seen people say they had test strips for 10 cents each. So you might as well get advice before you move ahead.

By the way, if you do buy from ADW (above) you can register first at www.mrrebates.com and get a rebate back on everything you buy at ADW.
Click to expand...
When you say the new dose should be .75, why? I have never adjusted yet due to a certain reading.
 
I *think* i've seen people say that the Relion Prime takes a larger drop of blood than the other Relions.

Let's suggest a reduced dose for you on Wednesday, depending on what happens between now and then. People do have to travel and some cats won't let anyone else test.
 
When a cat goes below a certain cut-off point - 68 on the AT, 50 on a human glucometer, that tells us that the dose is a little bit too high. You would reduce the dose at that point. It's a good thing!

Some of us have worked on info for people starting out in your shoes - trying to figure out what dosing guidelines to use is a pain in the neck, especially when the whole thing is new to people. Here's what we've come up with - see if it helps:

Info For New Members
Welcome to Lantus and Lev land – the best place you probably never wanted to be! If you are like most of us, if this is your first few weeks of trying to wrap your head around the fact that your kitty has diabetes, you’ve no doubt been terrified, in tears, in a state of shock, and completely overwhelmed. Don’t worry. It gets easier. It really does.


None of us here are veterinary professionals but many of us have been working with our cat’s diabetes for a long time. Even those of us who have been here for a short time are here to help. This is a wonderfully supportive community.

There are a few first steps. We firmly believe that home testing is the best way to keep your cat safe. We keep a record of our cat’s blood glucose (BG) data on a spreadsheet (SS) which you can create using these instructions: http://www.felinediabetes.com/FDMB/...te-a-ss-and-link-it-in-your-signature.130337/. If you’ve not mastered home testing, we’re happy to offer suggestions or you may want to spend some time on the Health board mastering the basics of testing, low carb diet, and getting your SS set up. We’re happy to help you with those things, but you should be aware that this is a busy board and if there’s an emergency, everyone’s attention goes to helping the caregiver and his/her kitty.


Once you’ve got a handle on the basics, you will have the option of following the Tight Regulation Protocol or the Start Low Go Slow (SLGS) method for managing your cat’s diabetes. You don’t have to stick with whichever approach you initially choose but it is helpful to give your choice a chance so you can evaluate the results fairly.

The Tight Regulation protocol was developed based upon the premise that a cat's pancreas may be able to heal and return to producing insulin if the cat's BG is kept in a normal range (i.e., 50-120}. Caregivers following this protocol adjust insulin doses following the protocol guidelines to aim for that range. Basic information on the TR is here: http://www.felinediabetes.com/FDMB/threads/lantus-levemir-tight-regulation-protocol.1581/. The advantage of this approach is that it is based on research published in a leading veterinary journal and has an admirable track record of getting cats who are within the first year since diagnosis into remission.


The Start Low Go Slow (SLGS) approach has caregivers start with an initial dose based upon the BG at diagnosis and whether kitty has been transitioned to a wet low carb diet, hold that dose for a week or two while testing for ketones regularly, being consistent with food and testing before shooting every 12 hours. Once a week a curve is done (test every 2 hours for one cycle) to check for the lowest point. the low number in that curve determines any dose change for the following week. This approach was the original method used in the FDMB prior to the TR protocol. It is an alternate approach if TR is not the right fit for you or your kitty. Basic information on the SLGS approach is here: http://www.felinediabetes.com/FDMB/threads/lantus-levemir-start-low-go-slow-method-slgs.129446/.


Both approaches require that you test at pre-shot times and do your best to test at least once each 12-hour cycle. Lantus and Lev dosing is based on the lowest number in the cycle (i.e., the nadir) so getting at least one spot check is important to guide your dosing decisions.


If you are switching to lantus or levemir from any other insulin, please post for suggestions on the starting dose before you change insulins. You should also get your vet’s recommendation.


Amy&Trixie, Dyana&(GA)J.D., Julie&(GA) Punkin, Marje&Gracie, Sandy&Black Kitty, Sienne&Gabby, Wendy&Neko
 
julie & punkin (ga) said:
When a cat goes below a certain cut-off point - 68 on the AT, 50 on a human glucometer, that tells us that the dose is a little bit too high. You would reduce the dose at that point. It's a good thing!

Some of us have worked on info for people starting out in your shoes - trying to figure out what dosing guidelines to use is a pain in the neck, especially when the whole thing is new to people. Here's what we've come up with - see if it helps:

Info For New Members
Welcome to Lantus and Lev land – the best place you probably never wanted to be! If you are like most of us, if this is your first few weeks of trying to wrap your head around the fact that your kitty has diabetes, you’ve no doubt been terrified, in tears, in a state of shock, and completely overwhelmed. Don’t worry. It gets easier. It really does.


None of us here are veterinary professionals but many of us have been working with our cat’s diabetes for a long time. Even those of us who have been here for a short time are here to help. This is a wonderfully supportive community.

There are a few first steps. We firmly believe that home testing is the best way to keep your cat safe. We keep a record of our cat’s blood glucose (BG) data on a spreadsheet (SS) which you can create using these instructions: http://www.felinediabetes.com/FDMB/...te-a-ss-and-link-it-in-your-signature.130337/. If you’ve not mastered home testing, we’re happy to offer suggestions or you may want to spend some time on the Health board mastering the basics of testing, low carb diet, and getting your SS set up. We’re happy to help you with those things, but you should be aware that this is a busy board and if there’s an emergency, everyone’s attention goes to helping the caregiver and his/her kitty.


Once you’ve got a handle on the basics, you will have the option of following the Tight Regulation Protocol or the Start Low Go Slow (SLGS) method for managing your cat’s diabetes. You don’t have to stick with whichever approach you initially choose but it is helpful to give your choice a chance so you can evaluate the results fairly.

The Tight Regulation protocol was developed based upon the premise that a cat's pancreas may be able to heal and return to producing insulin if the cat's BG is kept in a normal range (i.e., 50-120}. Caregivers following this protocol adjust insulin doses following the protocol guidelines to aim for that range. Basic information on the TR is here: http://www.felinediabetes.com/FDMB/threads/lantus-levemir-tight-regulation-protocol.1581/. The advantage of this approach is that it is based on research published in a leading veterinary journal and has an admirable track record of getting cats who are within the first year since diagnosis into remission.


The Start Low Go Slow (SLGS) approach has caregivers start with an initial dose based upon the BG at diagnosis and whether kitty has been transitioned to a wet low carb diet, hold that dose for a week or two while testing for ketones regularly, being consistent with food and testing before shooting every 12 hours. Once a week a curve is done (test every 2 hours for one cycle) to check for the lowest point. the low number in that curve determines any dose change for the following week. This approach was the original method used in the FDMB prior to the TR protocol. It is an alternate approach if TR is not the right fit for you or your kitty. Basic information on the SLGS approach is here: http://www.felinediabetes.com/FDMB/threads/lantus-levemir-start-low-go-slow-method-slgs.129446/.


Both approaches require that you test at pre-shot times and do your best to test at least once each 12-hour cycle. Lantus and Lev dosing is based on the lowest number in the cycle (i.e., the nadir) so getting at least one spot check is important to guide your dosing decisions.


If you are switching to lantus or levemir from any other insulin, please post for suggestions on the starting dose before you change insulins. You should also get your vet’s recommendation.


Amy&Trixie, Dyana&(GA)J.D., Julie&(GA) Punkin, Marje&Gracie, Sandy&Black Kitty, Sienne&Gabby, Wendy&Neko
Click to expand...
Thanks, Amy. I guess I'm doing the SLGS Method.
 
ok, then you would reduce when she goes below 90. From the SLGS:

  • 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.
 
julie & punkin (ga) said:
ok, then you would reduce when she goes below 90. From the SLGS:

  • 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.
Click to expand...
julie & punkin (ga) said:
ok, then you would reduce when she goes below 90. From the SLGS:

  • 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.
Click to expand...
Preshot testing is now 147. Should I give 1 unit as usual?
 
No you should give .75 Lantus dosing is based on the low point/nadir not the preshot number and her nadir was too low for 1 unit
 
i wouldn't be too concerned about her not eating right now since you fed just a little while ago. It is not essential that a cat eats right on shot time with lantus, you just want to know that she will eat, if a cat is completely off their food you need to be a little more careful with dosing.
 
Vyktors Mum said:
i wouldn't be too concerned about her not eating right now since you fed just a little while ago. It is not essential that a cat eats right on shot time with lantus, you just want to know that she will eat, if a cat is completely off their food you need to be a little more careful with dosing.
Click to expand...
Im sorry to be asking such annoying questions but, are you saying it is ok to give her the insulin now at her usual shot time even though she wont eat anymore? and give her .75?
 
If you can just leave her food down for her to have when she's ready. If there are others around who will nick the food then just offer it again in a half hour or so
 
I'm guessing that her shot is a bit late now, don't forget that means her next shot will need to be late too, you can pull back 15 mins per shot to get her back on schedule.
 
I agree with Serryn's explanation. She's done with 1.0u - the 0.75u is her new dose for now. Even if you see higher numbers, you wouldn't give the 1.0u without someone looking at it and telling you to go back to 1.0u. It's a safety issue.
 
julie & punkin (ga) said:
I agree with Serryn's explanation. She's done with 1.0u - the 0.75u is her new dose for now. Even if you see higher numbers, you wouldn't give the 1.0u without someone looking at it and telling you to go back to 1.0u. It's a safety issue.
Click to expand...
even though today was really the first day of low numbers?
 
Thinking I should explain a little further . . . a newly diagnosed cat has the potential for her pancreas to heal. When/if that happens, the pancreas can begin sputtering back to life and putting out some insulin. As the cat's own pancreas puts out insulin, we reduce the amount we're injecting. So you have a see-saw effect: her blood sugar drops below 90, you reduce the dose. She'll settle into the new reduced dose and if all goes well, she'll go below 90 again. Then you reduce the dose again. That's the path to going off of insulin and having a cat become diet-controlled.

Now it's not that easy with every cat! But with a newly diagnosed cat, we assume that they will "hold" the reduction, meaning their good blood sugar numbers will continue after a dose reduction. If they don't, then we go to plan B. But plan A is to take the reduction when she goes below 90 since you're following SLGS.

If she happens to go below 90 again in the next cycle or two, we might think that it's the former 1.0u dose to blame. When you reduce the dose, there is a delay in the time before the depot also decreases. Think of it as being timed-release - the depot for 1.0u is larger than the depot for 0.75u, and when you reduce to 0.75u it can take 4-6 cycles to equalize the depot and injection amount again. So if a cat goes low immediately after a dose reduction, say in the next cycle or two, we'd probably suggest you hold the dose 0,75u a little longer and see if it's really the 0.75u dose has become too much, or if it's still the 1.0u dose influencing blood sugar.

You don't have to remember all that, the point is simply that if Princess goes below 90 again tonight, you wouldn't reduce her dose again in the morning. Ask for advice if that happens to you.

It gets SO much easier once you've learned a bit more. The first weeks with a diabetic cat are so hard - it's overwhelming to almost everyone. But it does eventually become routine and it's not nearly so bad. People do this for years, literally, and it just becomes part of life. You'll get the hang of it before long!
 
julie & punkin (ga) said:
Thinking I should explain a little further . . . a newly diagnosed cat has the potential for her pancreas to heal. When/if that happens, the pancreas can begin sputtering back to life and putting out some insulin. As the cat's own pancreas puts out insulin, we reduce the amount we're injecting. So you have a see-saw effect: her blood sugar drops below 90, you reduce the dose. She'll settle into the new reduced dose and if all goes well, she'll go below 90 again. Then you reduce the dose again. That's the path to going off of insulin and having a cat become diet-controlled.

Now it's not that easy with every cat! But with a newly diagnosed cat, we assume that they will "hold" the reduction, meaning their good blood sugar numbers will continue after a dose reduction. If they don't, then we go to plan B. But plan A is to take the reduction when she goes below 90 since you're following SLGS.

If she happens to go below 90 again in the next cycle or two, we might think that it's the former 1.0u dose to blame. When you reduce the dose, there is a delay in the time before the depot also decreases. Think of it as being timed-release - the depot for 1.0u is larger than the depot for 0.75u, and when you reduce to 0.75u it can take 4-6 cycles to equalize the depot and injection amount again. So if a cat goes low immediately after a dose reduction, say in the next cycle or two, we'd probably suggest you hold the dose 0,75u a little longer and see if it's really the 0.75u dose has become too much, or if it's still the 1.0u dose influencing blood sugar.

You don't have to remember all that, the point is simply that if Princess goes below 90 again tonight, you wouldn't reduce her dose again in the morning. Ask for advice if that happens to you.

It gets SO much easier once you've learned a bit more. The first weeks with a diabetic cat are so hard - it's overwhelming to almost everyone. But it does eventually become routine and it's not nearly so bad. People do this for years, literally, and it just becomes part of life. You'll get the hang of it before long!
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oh, now i see your comment.

You hold the dose at 0.75u - Lantus dosing is based upon how low a dose takes a cat. To some extent we ignore the highs. If you get the urge to increase, ask someone to take a look. Bounces can cause high numbers and we don't increase based upon them.
 
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