Question regarding doses

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miaomi

Member Since 2013
I started testing my cat again. My cat's BG number is still high. My vet said her urine trace infection causes the number higher, and wants to decide if or not adjust her does without the infection. My cat needs antibiotics for ten more days, and I don't feel safe enough to wait that long. The vet needs a urine culture to make sure there is no more infection after finishing the antibiotics. My question is that can I increase 0.25 when her number is above 300 or 350, and keep 1 unite when below 300? I always feed her first then test her and give insulin, is this correct? And could you tell me if you can see that she has a bounce, if so what should I do. Thank you!
 
Lantus is based on the nadir of the cycle. Dosing should be the same for both shots. If it were me I would go up .25u and keep up on the antibiotic. What kind of antibiotic are you using Waiting can cause all kinds of problems like DKA. Are you testing for ketones also? You dont have to have the vet permission to change the dose. If you are following the tight regulation protocol for Lantus, you will see that you can change a dose after 3-5 days (6-10cycles).

"General" Guidelines:

Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).

Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).

Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.

Increasing the dose:

Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.

After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.

After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.


Reducing the dose:

If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. See additional notes in the next paragraph about drops into the 20s and 30s. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.


I encourage you to read the stickies on the Lantus TR forum to learn everything about Lantus. Also start posting numbers on the forum and start getting some help on dosing.

Lantus Tight Regulation Board
 
She has taken clavamox. I'd like to start increasing 0.25unite tomorrow if her number is high. Thank you.
 
Her BG was 432, I am giving her insulin in 10 minutes, it's hard to measure 0.25, can I give 0.5 instead or it's too much?
 
Mao has had high numbers from yesterday to today. I increased 0.25u this morning, it has not worked for her so far. She wants food all the time, and finished 4 cans already, does her food bring up the number, What should I do? My vet is not happy about testing her, she thinks I should wait until she is done with antibiotics, then make a decision on does. but I don't feel comfortable with her BG numbers,
 
I just got an email from my vet, she said I can give her 2unit every 12 hours, but I just increased it to 1.25u this morning(I cannot tell the vet about it), is it OK to give her 2U tonight? Please help. Thanks.
 
Sorry nobody got back to you in time.. its a busy time of year!

Lantus is a depot insulin which means it takes a few days for a dose to build up in the cats system and for you to really know how the dose is working. Which is why its critical to let any new dose settle for a few days before changing it. You also only want to increase in 0.25 units because any more than that and you can miss the good dose and start a chronic bouncing cycle.

Since you are at 2.5 now I would test more and hold this for a few days to see how it goes. IF at any point she drops under 50, you must decrease immediately. She could drop fast and increase within a space of 12 hours so I would definitely get both pre shot and mid cycle tests.

Wendy
 
Thank you Windy. After increasing the does from 1u to 2u, her BG reading dropped sharply from 400 range to 170 & 97, I did not know if or not I should shoot when her amps reading that low, I choose not, but her next preshot reading would be back to 400 range. I am wondering if the 2u is too much for her. I definitely test her more. Julie
 
2 units appears to be too high because you weren't able to give a shot.
Maybe drop down to 1.5 units AND HOLD IT FOR AT LEAST 3 DAYS, unless the cat goes below 50 mg/dL
 
I agree with BJ - lets try a dose decrease to 1.5.

A few things to note

You will probably see high numbers for a few days now because of her body reacting to dropping low. Don't panic! Hold the 1.5 unit dose anyway.
Also it will take a few days for her higher dose to drain out her system and really see what effect that new dose has - which is why BJ is saying to hold the new dose for a few days!

So hold this new dose at least 3 days - unless she drops under 50 ( if she does, drop the dose again) and we will re-evaluate then

Wendy
 
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