Vet pleased with progress - now on 4 units x twice daily

[Anyname]

We are trying 4 units for a few days in the hope of getting the numbers down a little. Vet said there is more to this than numbers - but thinks 4 might be worth a go. LB's behaviour and eating/peeing all count towards assessment of success. LB's greatest achievement is his cholesterol has halved. Down from over 10 to 5. I wonder if it's the low carb diet? Many other readings from latest blood test show improvement. Can those with wisdom have a quick look at the spread sheet under Little Boy and see if they think we have gone too quickly to 4 units. Vet would like to see much lower numbers but admits that it takes time.

Marilyn

 

[Sienne and Gabby (GA)]

I think the move to 4.0u should be taken in steps of 0.25u. I'm not sure how you are measuring 3.20 vs. 3.25u or 3.5 vs. 3.6u. Regardless, as long as you can measure these amounts consistently, it's fine. Do review the dosing protocol that we use here. From the modified protocol:

Increasing the dose...
--- Hold the dose for 3 - 5 days (6 - 10 cycles) if nadirs are less than 200 before increasing the dose.

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

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

Little Boy's nadirs are between 200 - 300. Thus, you would raise his dose in 0.25u increments. You should also be holding the doses for 3 days. Increases in Lantus doses need time to stabilize. Remember, you need to make sure you have filled the shed before you increase to the next dose. You've been shifting around the dose. In some cats, a drop of insulin can make a difference. The more inconsistent you are with the dose, the greater the chance that numbers will look weird. So, FWIW, if it were me, I'd stick with the 3.75 for three days (6 cycles) and if the nadir is still in the yellows, then increase to 4.0u.

I'm not sure how you are measuring cholesterol. It's not the typical units that we use. Many cats have high cholesterol. Unless the blood work was done on a fasting sample, the results may not mean a great deal. To be honest, most LC food has a high fat content.

 

[Anyname]

I've been guessing the amounts - I read some of the posts re advice for Lantus and they had pictures of a syringe which indicated the amounts. We tried a lot of places to get syringes with .5 of a unit but no luck. I got worried the other day when the BG amount was as high as it was at dx. I don't think he had eaten for 2 hrs so I panicked. Vet has also been bugging us to go up to 4 units. I tend to think if I keep a close eye on his BG then it's not a bad thing to get the numbers down a bit. I keep thinking that all the while that he's having high numbers permanent damage is happening inside him. :sad:

On a different subject I bought Kangaroo meat today. LB loves it. It's not expensive and I think it must be good for cats. I love Kangaroo's so it's awful to think my cat is eating its meat but I love cows and chickens too.

 

[Monique & Spooky]

On a different subject I bought Kangaroo meat today. LB loves it. It's not expensive and I think it must be good for cats. I love Kangaroo's so it's awful to think my cat is eating its meat but I love cows and chickens too.

I understand :cry: But it sure is amuzing to picture a cat chasing down a Roo! :lol: Glad he likes I have heard it is good for them.

About the syringes....I recall others in AU had trouble finding the BD .3ml Microfine +Demi syringes. One member I think (Andrew & Mim) odered them from the US I don't know how expensive it was. It is possible to use the whole unit marked syringes (Regular Microfine) just be sure to the 0.3ml ones. I used those for a bit until I could order the half unit ones.

http://www.diabeticpromotions.com/m...ct_Code=8440B&Category_Code=InSupply-Syringes

Other AU members have ordered these syringes and they do ship to AU, the cost is about double though. They make dosing so much easier.

LB's numbers are not dangerously high and your testing shows that he is responding to the insulin. It does take time (and patients :? ) often we don't really see the results of what a dose can do until several days. Given his numbers and the fact that you are testing for ketones (I assume with the Precision meter) he is not in a range where serious damage is goinging to occur. You don't need to be overly agressive. I would say given the syringes you have to work with try a dose that is about one "hair width" under the 4 unit mark (call it 3.75 units) and try to keep it consistant for at least 3-4 days before deciding to raise it. Keep testing as much as you can (obviously if he goes to low on that dose you need to decrease back to 3.5U) If you are making any diet changes you will need to watch closely as it can lead to significant changes in BG and response to insulin. The more changes you make all together the more difficult it will be to determine the cause-effect relationship (true in any experiment).

About Ketones in blood using the ß-Hydroxybutyrate method: A blood ketone level less than 0.5 mmol/L is considered to be physiological,
hyperketonemia is defined by a value greater than 1mmol/L and ketoacidosis is considered to be probable above 3 mmol/L.