Spreadsheet up - need a little advice

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Nancy&Pepper (GA)

Member Since 2012
I can't believe I got the spreadsheet working! I spoke with Pepper's vet. He wants to increase his dose of Lantus to 2 units twice a day. I keep reading "Start low, go slow" so I would like to know if this is too big an increase? He said I could try 1.5 units if I preferred to do that.
 
Hi Nancy. Congratulations on home testing and getting the spreadsheet set up. I would suggest that you open a post in the Lantus TR forum for more eyes. We generally tell people to stick with the intial dose for 5 to 7 days, and then to do dose adjustments in quarter units, so your next dose would be 1.25, if and when you do an increase.
Vets are not used to doing dose adjustments the way we do, and I think our way is the safest way to go.
I hope to see you over there.
 
Hi Dyana. I was actually going to go with the relaxed appraoch. Should I still post in the TR forum or the relaxed Lantus forum?
 
I would go to the TR forum and let them know you are thinking of using the relaxed method. They help both on that forum, and there are a lot more people there to help you. You can add Using Relaxed Method or something like that to your signature, so the people helping you can see at a glance how to help you best.
 
Nancy,
Please do post over in the lantus forum. Yes I agree that a full unit is too much. If he were mine, I'd go to 1.5 BUT there are missing numbers for today. I even hesitate posting advice as I can't stay and answer further questions. I don't usually give advice because this happens too often.... :roll: but I noticed a while had passed since you asked. GOOD JOB getting spreadsheet up! Start in TR then decide how you want to proceed. We post in TR but we do whatever dance KT choreographs...

BIG HUG!!!
 
Hi Nancy,

Given Pepper's numbers I would say a .5u increase is appropriate, but we never increase the dose in whole units. If you do that, you risk going over the right dose, and once you're in overdose territory it can be deceiving because most of the time numbers will look just as high as if there isn't enough insulin, especially if you're not getting daily nadir tests.
 
Hi Nancy. Julia convinced me I could do TR, even with a busy schedule. It seems overwhelming at times, but these wonderful people on here will help you every step of the way, if you let them.
No question is rediculous, and no item of concern too small. Thanks to their advice, Tucker is in remission.
Best of luck! cat_pet_icon
 
I was about to say something to that effect, but I didn't want to be too pushy. But, I think I'm going to anyway. ;-)

If you're getting at least three tests a day (the two preshots and a nadir), then you can do TR. I managed to do it working two jobs and going to grad school, so I'm not someone who was home all the time to test. I would always recommend newbies start with TR first, and then go to something more relaxed if it's just impossible for TR to work for them. That's because the 86% remission rate with Lantus is only associated with TR, so it offers you the best chance of getting to remission. But there's a window on remission and TR, so the sooner you start it, the better your chances.

To give you an idea of how I managed it, here's what I did. Bandit's shots were at 7am and 7pm, and his nadirs were typically 6hrs after each shot (1pm/1am). I tested and gave him his morning shot and food, and then I had to leave for work for nearly 12 hours (I have an hr commute both ways). So I set the autofeeder with frozen food and set it to go off at his nadir (1pm) so that he had food available if he dropped a little low. I got home just before 7pm and tested and gave him his PM shot. Then I got a test before bed (+2-+4), and I set an alarm to get up at 1am and get his nadir test every day (+6) and went right back to sleep. That seems like a pain, but after a week or two I adjusted and it was fine. On the weekends when I was home to test, I would do a curve in his AM cycle and get some extra tests in when I could.

It is a little bit more work, but it actually SAVES you a lot of work and stress in the long run. A cat in remission is far easier to care for than a cat on insulin, and it's the healthiest place for a diabetic cat to be, so it's win/win for both of you. If there's no secondary health condition that might throw off his BG, it's very likely your cat will reach remission with TR.
 
Thanks to everyone for their advice and the words of encouragement help more than you know when I am feeling overwhelmed - which is most of the time! Sorry I didn't post a reply sooner, but on top of everything else, I've had out of town visitors and it's been crazy around here. Several people brought up the subject of trying tight regulation. But Pepper isn't newly diagnosed. He was diagnosed a year ago. The vet put him on Novolin N (same as Humulin), Purina DM dry and never said anything about testing. I found this site this summer and learned there were much better insulins, dry food is poison, and home-testing is a must. After reading and reading the posts here, I thought there wasn't a great chance he would go into remission after this length of time. Am I wrong? Plus, I have to admit, tight regulation seems overwhelming.
 
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