Recently diagnosed question about curve and insulin dose

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Blackydaisy

Member Since 2013
Hi, I'm new and my blacky was recently diagnosed.

We were diagnosed little over a week ago. I've been using the alpha trak but I just started using the relion micro. Blacky was hospitalized for 3 days due to severe dehydration. While staying at the hospital he was given 2 units of lantus twice a day but after the third dose the vet decided to decrease to 1 unit, but then also after the third dose it was changed to 1.5. At the hospital they were feeding w/d wet. but after reading this wonderful site I changed the diet to FF. I took the new food to the hospital and told them to only feed FF. The new dose of 1.5 units was a little before the diet change. After one day on FF and when my blacky was discharged they changed the dose again to 1 unit lantus twice a day. So I started doing my own testing using the Alpha trak.

My question is how do I know when to decrease the dose because sometimes I skip a dose. His numbers are not high but they are not that low either. I haven't started the spread sheet yet but so far since last Wednesday (when he came home) the highest number has been 233 but only once most of the time he is between the 120's-190s AT numbers. one time he had a good nadir number of 86. is it ok to be skipping doses? The vet said to try and see how he does with 1 unit once a day. Also his feeding schedule is as follows: I usually give him 1can after insulin even if I skip the dose and give 1/2 a can around or try to give it at mid cycle. He's very hungry although he's not crying for food between meals as often anymore. But he also lost a lot of weight in a very short time he was just skin and bones. He's still skinny but I'm starting to feel a little bit of muscle on his legs.
Should I keep the same feeding schedule?
 
so It's ok if I skip some doses? or do I keep checking until it's over 150 to give the shot if the PS is too low. :?:
 
Read the sticky on that page on shooting low preshots. It'll give you some choices. We do tell new diabetics not to shoot a preshot under 200. The usual advice is to wait 20 minutes without feeding and retest - to see if the number is over 200 and definitely rising. Skipping is problematic with Lantus as it drains the depot he has built up, it is the least desirable choice.
 
Hello and welcome to the board!

Its great you are all set up with food, testing and even a SS! His numbers look pretty good already.

In terms of food - what is his weight and how much does he eat a day? Unregulated diabetic cats usually need more food to sustain themselves. I would feed more but watch his weight - weigh him once a week and adjust food accordingly.

In terms of dose, Lantus is a depot insulin which means it needs time to build up in the cats system and before you really see the impact of the dose. Because you have to keep skipping shots, this means the depot isn't properly full. So I would suggest you drop to 0.5 unit and give it every 12 hours. (I would not just shoot once a day because the Lantus wears off and it means he goes 12 hours without insulin and his blood sugar creeps up - shooting twice a day will allow more control and keep him in more healing numbers.)

If he drops under 50, then reduce the dose to 0.25 immediately. Otherwise we want to try and hold the same dose for a week to let the depot fill.

Also I wouldn't shoot under 150 for now.


Wendy
 
Welcome Blacky and Blacky's Bean! :YMHUG:

I agree with Wendy. Lantus needs to be dosed twice a day, so you need to find a dose that is safe to give twice a day. If you find yourself skipping shots, then you will want to reduce the dose. Wendy's suggestion of .5u BID (twice a day) is a good dose to try. With the food change, he might even soon need less than that. It's great that you're already testing! :thumbup

Here's a link for some help with the spreadsheet we all use.
 
Thanks to all of you for the replies :-D
That sounds like a good idea to me too to drop to 0.5 units twice a day. I don't have a current weight but when he was first diagnosed his weight was 6.4 and when he was discharged he was 6.8lbs. I know he gained a little more this last week because I can feel some muscles and he seem a touch heavier. I usually feed him 4 times a day meaning 1 can after every shot and 1/2 a can in between shots as snaks. So a total of 3 cans a day.

Ok so if I do 0.5 unit twice a day and he is under 150 with my relion meter on one of the PS's do I still give it but give a little less than 0.5 unit??

Also, when I give him his 1/2 can it's uasually around nadir time is that ok? I am only home for one of the nadirs because of work but my mom is there for the other one and she feeds but she won't test him.

Thank you! :smile:
 
Blackydaisy said:
...Ok so if I do 0.5 unit twice a day and he is under 150 with my relion meter on one of the PS's do I still give it but give a little less than 0.5 unit??

Also, when I give him his 1/2 can it's usually around nadir time - is that ok? ...
Click to expand...

The 0.5 units is fine.
If he is under 150 at pre-shot, without feeding, wait 30 minutes (ie stall) and retest. If he is rising, it should be OK to shoot. Otherwise, check in here.

As you get data, you may learn to shoot low to stay low. We want to be sure of your cat's response before having you get there, though, for safety.
 
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