Should I give dose with 156 reading?

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Nicksmom

Nicksmom

Member Since 2013
Hi, I did not introduce myself properly on my first post on other topic, but I am Barbara, and my sugar boy is Nicholas.
He was on Humulin N when first diagnosed in Jan 2013. He did well on it but then he began to get higher numbers, so vet changed him to Lantus. His last Humulin dose was 4u (started on 1u & upped as per vet one unit at a time until final 4u). Lantus he started Nick on 3u and numbers were still in 400s, so upped to 5 units. I have been home testing now for about a month, twice a day, three if Nick lets me. He also has heart issues and is on Enalapril 1/2 tab 2x daily. So if he will not let me test three times I do not want to upset him as it will affect his breathing. Throughout Oct, he was in 200-250 range. Then Oct 30 after lunch he was 154. I gave usual dose at night 8:20pm. I try to shoot him at 8:20am and then 8:20pm.
November 2 after lunch he was 201.
November 3 before breakfast he was 208, I fed at 8:15 and gave his dose. At 3pm he was 112 - and I jumped for joy. at 8pm two hours after his 6pm dinner, he was 488. Oh NO! gave him his dose at 8:20. at 1;47am I tested and he was 395.
He was so upset with all the testing on Nov 3rd and he was over breathing yesterday, so I gave him a rest and just gave him usual dose morning and night and his heart meds as usual.
Today - after praying to St Francis in a not sleeping much night, this morning I saw that he was breathing easier and was acting himself. I got some 9 LiveS Liver & Bacon and Super Supper, just for a change as he gets complacent with same food over time. He ate it up but not ravenously, so I was thinking, perhaps his numbers are good. He even left some food in the dish. I fed him small meals during the day, the last one about 2:30pm
I just tested him now before feeding his dinner - I took advice of someone on here who I read suggested using raw piece of chicken to distract from poke. It worked (or unless Nick was thinking, "Oh we're doing this again?" and just went with it this time.)
His number was 156. Feelings of joy again. But now his normal dose will be at 8:20pm and I am wondering should I give him just half his normal 4 units or should I give normal dose? Oh and I did not feel good about the 5 units vet suggested, so I eased down to 4 units over weekend and he has been getting 4 units since Friday night Nov. 1
 
I got to tell you without a spreadsheet so I can see the same numbers as you are it is impossible for me to tell you if it is safe to shoot or not.

Especially at 4u which is a large dose of Lantus which works entirely different than Humulin N.
First N is an " in and out " insulin which means it goes in does it's job and is out of the system by the end of the 12 hours. Lantus is a depot insulin which means it builds up a deposit under the skin so each shot builds upon the next one.

Personally if I was switching a cat from Humulin N to Lantus I would reboot and start over a 1u twice a day and work back up the dosing scale correctly for Lantus. With Lantus you hold a dose for at least a week then base dose changes off the nadir not the preshot values. If dosed correctly you will need much less Lantus than Humulin N which at best only lasts in cats about 6 hours where Lantus can last anywhere from 12 to 18 hours.

Mel, Maxwell, Autumn and The Fur Gang
 
I went with 3u at 8:20 as I did not see a reply at 8:15 so I did 3.
Now if I reboot, should start tomorrow morning 8:20? And then test at 2pm to see how he is doing with that? If pre-breakfast test is 200 should I still do reboot to 1u to see how he does?

I just started home testing last month, and am still new to it and spreadsheets. I have the few readings I've done in a log book so do I just transfer that info to a spreadhsheet? I saw the link of how to create spreadsheet, so I will do that tonight.
Thanks!
 
Yes you would just start tomorrow morning with the 1u. Then try to grab a spot check around +6. Now with Lantus it takes about 3-5 days for the shed to adjust or settle so you are going to want to hold that dose at least that long. Then about once a week when you have a free day and he is willing run a curve (testing every 2 hours between shots) and depending on that nadir decide if he needs a dose increase.

Mel, Maxwell, Autumn and The Fur Gang
 
Ok I will do that. Since Lantus hangs in system for a while, it should not be too shocky to him from tonight's dose, right?
Just was wondering - what do any of you say when vet asks why you changed dose they prescribed?
 
At 12:15am I tested, and he was 274. But after the 8:20 poke, he ate around 10pm and then he had raw pieces of chicken gizzards and I tested immediately following that. I know food brings up number. I figured if I test immediate after he had some gizzards he would be cooperative but when I saw the number, I remembered he ate also at around 10pm. ohmygod_smile He had the 156 read just before I fed him at 6pm. I tested, then gave him din din at 6.
 
Actually my vet asks me what dose Autumn is on. lol Seriously they know I home test and they have a link to her spreadsheet so they can see what her dose and her readings at any time.

However, I also adopted both of mine as diabetics so my vet wasn't the ones that diagnosed or started them on insulin. But I have a treasure when it comes to vets and they were willing to learn from me. Now I'm the one they call to help with new diabetic pet parents and Dr. Tami uses my two as case studies when she teaches at the local college.

Mel, Maxwell, Autumn and The Fur Gang
 
Like Mel said, you need a spreadsheet. I wish I could remember how to do it, had mine almost a year. If no one here knows, try posting on Health Board for help with the spreadsheet. There is a member that did mine for me and does them for many people when they are new. I'm sure she will find you.

You may not realize, but too high a dose can also cause very high numbers, that's why Mel suggested starting him over with 1U. After that, usual increase is .25-.50U at a time, holding the dose for several days to give him a chance to 'settle in'. If you keep increasing by full units, you may miss his best dose. Hopefully, in time, the testing won't bother him so much, poor baby.

Best of luck to you and welcome.
 
Ok did spreadsheet. big spaces is when I was nervous to test in case high, so waited til later in day. If I got good number, I got nervous to "tempt fate" and waited til next morning. Also if Nick got upset from multi test in a day, I left him alone til next day. If he flinches with first poke and no blood, I know he is nerved, so if I poke again get blood & test, anxiety may up number.
At Vet, he was getting numbers 500*-600. But now I know that must have been anxiety because at home he's never gotten THAT high.
Oh thanks for telling me about emailing spreadsheet to vet. I will try that & see how that goes.

With this last number at +6 this afternoon, do I stay dose at 2.50 and wait to see if it settles, Or give full at 8pm?
Thanks for help, as I am still learning. And coming here to ask help to stave some of my panics.
 
With Lantus you consistently give the same dose regardless of the preshot numbers. All that tells you is that it is safe to give insulin. In fact in the very beginning we tell you not to shoot any number under 200.

Mel, Maxwell, Autumn and The Fur Gang
 
Ok so I should stick with the 2.50 at 8pm? And stick to that for several days.
He had dinner at 6pm which was an hour ago, so test would be up due to food. I will juice him at 8:20 and then test him at midnight and give him his snack after.
Ok dose stays same regardless of pre-shot numbers - unless under 200, then no juice.
 
Okay my crew is fed for the evening so I can write a little more in depth post.

If you haven't already when you have time pop over to the Tight Regulation forum and read the starred stickies there they explain how to dose with Lantus. Normally we start cats at no higher than 1u twice a day. And then slowly work up in dose if not enough.

With Lantus all dose changes are based off the nadir or the lowest point in the cycle or the period between one shot to the next.

The cat earns a dose reduction anytime you get a bg test below 50 of a quarter unit.

I highly recommend testing 4 times a day when possible. Mandatory twice a day at preshots. Then various spot checks when possible. And a before bed check. Just to make sure they are up enough to feel comfortable sleeping and leaving them alone. Then running a curve on a day off before deciding if you need to raise the dose. Reduction are given immediately on the next shot.

Lastly keep asking questions the only stupid question is the one that goes unasked.

Mel, Maxwell, Autumn and The Fur Gang
 
Ok thanks, I will go over to tight regulation and read up.
His numbers not great today, but he is acting fine, eating, pooping, etc. Not acting "out of it". He ate at 6pm, so will test at 8:15 pre shot.
4 times a day. I will try. 2 I can get him to cooperate, and possibly 3.
Though this afternoon, he was cooperative for +6 I was surprised. Unless I just poked a part of ear he did not feel much.

Oh, would be safe to start him over at 1u when he's been up to 4 and now I've dropped him to 2.50 only yesterday? Or should I stay with 2.50 for few more days testing 3-4 times a day?
 
Leave him where he is for now and let him settle for a few days. He's had his dose bounced around and his shed needs to catch up.

Are you testing for ketones?

Mel, Maxwell, Autumn and The Fur Gang
 
Will be getting urine test strips tomorrow. Ran out. He was negative when I last checked 300+ BG
Didn't pre-shot at 8:15 because he ate more at 8pm. Gave him 2.50 at 8:15 and will test him at midnight to see.
Will stay at 2.50 to settle him in. He is not ravenously eating, just regular and drinking normally, not excessively or hanging in area of the bowl. Peeing/pooping normally - no rivers or thimble amount,
 
Just wanted to make sure you were testing periodically for them. :-)

He more than likely need to go up in dose but lets see how he does in the next few days. We can always go up but we can't take it back out once it's in the cat.

Mel, Maxwell, Autumn and The Fur Gang
 
Maybe he needs to go back to the 4u. He seemed to have more blue & yellow at that. And started the highers when I went to 3 and then 2.50. But will stay at 2.50 til over weekend and see. I gave him 9 Lives & Friskies Sp Diet Turkey & Gilbets the past 3 days, but after today's +6 gave him FF only for lunch & din.

Just smelled his civvie bro Jeremy's breath, and then smelled Nick's when I gave him his Enalapril, and they both smelled same. Usual bad Cat Breath. No nail polish or urine smell.
 
Ok, he needs to be raised with the readings from last night at 12:30am and this morning AMPS.
Should I go to 3u or back to 3.50u. At 4u he was managing into 100+ nadir. Anxious. :sad:
 
Lets take him back to 4 I'm thinking his other meds may be a factor so need to shoot around them.

Mel, Maxwell, Autumn and The Fur Gang
 
Oh THANK YOU for coming on so soon!
I do feel better at putting him back at 4u.
Its an hour passed his normal juicing, so I will test again at 3pm instead of 2pm.
Again thanks for confimring as I was thinking.
 
Your welcome hun. I have two cardiac cats myself but mine are civies so never had to worry about dosing around their meds.

Since you are shooting late today that is going to reset your shot time tonight. With Lantus you can only adjust shots by 30minutes max per day. So to get him back to his normal juicing time you can shoot a half hour early tonight, then back to his normal time tomorrow morning.

Mel, Maxwell, Autumn and The Fur Gang
 
Ok so his normal juice time is 8:20 am and 8:20 pm SInce I juiced him at 9:20am, I should juice him at 8:55/9:00pm tonight?

Oh I'm even more grateful that you have taken me on since you also have cardio cats. Are yours on Enalapril? I asked a question on the Health forum about Daily Best vitamins and posted link to its ingredients and Guar Anal. I wanted to know if this is ok to give to Nick as a supplement.
 
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