ready to up the dose?

Status
Not open for further replies.
Hi Yolanda! I don't think I've met you yet - so welcome to you and Whiskers.

Following the SLGS guidelines:

Starting Dose
  • 1u BID if kitty is not on a wet/canned low carb diet
  • 0.5u BID if kitty has been switched to a wet/canned low carb diet
  • If the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration
  • Generally, shots are to be given 12 hours apart.
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.

  • 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
  • As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], do lengthen the waiting time between dose increases. If you decide to change another factor (e.g., diet or other medications), don't increase the insulin dose until the other change is complete (but do decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change). Don't be tempted to rush the process along by increasing the dose more quickly or in larger increments-- no matter how high your cat's blood glucose is! Rushing towards regulation will cost you time in the long run, because you may shoot past the right dose.
Lather, Rinse, and Repeat!​


It looks like the lowest he's getting on this dose is in the upper-100's, at least occasionally. I highlighted the part above that I think would apply to Whiskers at the moment. So yes, you would increase his dose by 0.25u.

There aren't any syringes marked with 0.25u, unfortunately. There are photos on the "New to the Group?" sticky of tiny doses - take a look at those and see if it's helpful. The main thing is that you want to be able to repeat his dose again, and also be able to increase or decrease it when needed. Your 0.75u doesn't need to look like mine - you just want to be consistent yourself with what you're calling 0.75u. You might want to take an old syringe and use colored water to give yourself a sample to compare against.
 
Whiskers probably is ready for an increase, although it is hard to say for sure since there is some missing data for several days and most evenings. Lantus dosing is based on the nadir, rather than preshot values, so it is important to grab some mid-cycle tests both during the day and the evening. Today's curve is great information and certainly helps us see what Whiskers is doing with his juice! In between curve days, if you could grab one extra test in the morning, and one extra test in the evening, it would help a lot with filling in the other blanks about how Whiskers is doing.

Julie and Ella have given you great info about how to get a .75U dose!

Welcome aboard, Yoland and Whiskers!!
 
Yolanda, if you still have some old syringes, you might want to use some of them and pull up .5 in one and 1 unit in another using some colored water/tea/coffee/juice so you can really see it and then with a 3rd syringe, try for a dose in between (.75)

Then when you've got one you're happy calling .75, keep it to compare to when you're measuring the insulin dose

Good luck with the dosecrease!
 
I ended up using a metal ruler to measure out the doses as I found the syringe markings a little inconsistent.

Yolanda has also started a thread on the main health forum as whiskers is having trouble with a little diarrhoea and back leg problems and she was concerned it might be the increase in insulin. I have advised that I don't think it probably is and mentioned neuropathy but have linked it here in case members want to comment

http://www.felinediabetes.com/FDMB/threads/runny-poop.133823/
 
Hi yolanda @kittymomma_of3 how are things going?

I see you have had a few no shots. Is that because you were concerned about the preshot number? If it was that you can always start a thread on here asking for advice on whether to give the insulin.

It looks like it might to time to think about a dose increase but others will advise.

Are you checking for ketones whilst the glucose is still a little high.
 
phlika29 said:
Hi yolanda @kittymomma_of3 how are things going?

I see you have had a few no shots. Is that because you were concerned about the preshot number? If it was that you can always start a thread on here asking for advice on whether to give the insulin.

It looks like it might to time to think about a dose increase but others will advise.

Are you checking for ketones whilst the glucose is still a little high.
Click to expand...
Hi ! the no shots where were my husband wasnt sure to shot or not....was hoping he would call me instead, now he knows....how do i test for ketones?
 
I wonder if it is time to increase to 1 unit. Can someone advise. I know yolanda is following the SLGS protocol, she has held the dose for over seven days but there have been a couple of no shots.

As her nadir is still over the 150 can she go ahead and increase to 1 unit now?
 
SLGS calls for doing a curve once a week and deciding on a dose increase based upon that. I'd go for the every 3 hours for 18 hours curve, personally, just because it would spread over 2 cycles and give more information to help make the decision.

edited to add:
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.
 
Last edited:
will be doing curve tomorrow, will be doing the 3 hour/18hour curve......whiskers has been a really naughty boy( prefer to see him naughty than sick), he has been running and jumping :cat: and stealing my sons socks and running:smuggrin:
 
Yolanda

That's good to hear whiskers is back to his naughty self. Good job doing the curve, then we can really see how things are going.
 
Status
Not open for further replies.
Back
Top