? Dosing Advice Needed

Discussion in 'Lantus / Levemir / Biosimilars' started by bxkitty, Oct 27, 2018.

  1. bxkitty

    bxkitty Member

    Joined:
    Oct 23, 2018
    Hi Everyone,
    I need help figuring out 'acceptable' GB levels for my cat. I mislabled my previous post and trying to make sure it doesn't get lost in the shuffle.

    Here it also is for easier access:

     
  2. Riin

    Riin Member

    Joined:
    Sep 25, 2018
    EST as from Estonia?
     
  3. bxkitty

    bxkitty Member

    Joined:
    Oct 23, 2018
    Nope! As in Eastern Time Zone :)
    I just saw your signature says "from Estonia." Sorry to disappoint xD
     
  4. Dyana

    Dyana Well-Known Member

    Joined:
    Dec 28, 2009
    Using an Alpha Trak meter, that 65 yesterday would mean she needs a reduction in dose. Do you have the syringes with 1/2 unit marks?
     
    Joanne&TinySole likes this.
  5. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    What's "safe" depends on a few factors. First, you need to have sufficient data to have a handle on how your kitty responds to insulin. Based on the information on your spreadsheet, you haven't had a chance to collect all that much data yet.

    Second, how low you shoot once you have the data, depends on which approach to dosing you're using. With Tight Regulation (TR), you typically shoot lower numbers (e.g., I would shoot anything over 50 on a human meter). Start Low Go Slow (SLGS) uses a higher point although we often encourage people to shoot progressively lower once they are data ready.

    The challenge with Sophia is that she's in great numbers already!

    As Dyana noted, you will want to reduce Sophia's dose to 0.75u given that she dropped below 61 (65 is the point for a reduction using TR with an AlphaTrack meter).

    Most vets get very nervous with our shooting low. This is likely the case because the majority of caregivers do not home test or are not confident with regard to steering lower numbers with food. In order to shoot low, you need a couple of essentials -- high carb food, extra strips, and the ability to be home to monitor your cat. (See the Shooting & Managing Low Numbers sticky.) However, as a cat's cycles flatten out, typically shooting low with Lantus, keeps the cycle flat. There are exceptions, though, so it's not safe to shoot a low number and leave your kitty unattended.
     
  6. bxkitty

    bxkitty Member

    Joined:
    Oct 23, 2018
    @Dyana I only have whole unit syringes :\ However, I'm choosing to try and watch her levels, especially before eating and judging then if I should give her a shot or not for that part of the day.

    @Sienne and Gabby (GA) Woah. I'll have to read up more about the shooting techniques you mention. I tried glimpsing at it, and it's a lot of info to take in at once. Since I'm the only one managing Sophia's treatment, I make sure to not do too much if I know I'm not going to be home to really look after her. I also feel like her dosage may need to be adjusted based on the advice I've been given, but I don't have 1/2 unit syringes and wouldn't feel comfortable adjusting dosage without consulting my vet first.
     
  7. rhiannon and shadow (GA)

    rhiannon and shadow (GA) Well-Known Member

    Joined:
    Jul 9, 2012
    imho, you need to get comfortable with adjusting dose.... Insulin needs do not stay constant. They can go up or down depending on several other factors. Remember, you are the one that is with her each day and know if she is eating properly and behaving normally. The vet just looks at numbers and there have been many examples where a vet sees a high number and raises the dose when it should not have happened.
     
  8. bxkitty

    bxkitty Member

    Joined:
    Oct 23, 2018
    @rhiannon and shadow (GA) You make good points. And yeah, I agree with you in terms of getting comfortable with adjusting the dose. It's just that the more info I get, the little bit more overwhelmed I feel and just need a bit of time to adjust, you know? And I appreciate your advice :)
     
  9. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    There's no rush. Read and ask questions. We want you to understand why we're suggesting what we're suggesting so you do feel comfortable. The point that I started trusting the feedback here was when it was a Saturday evening and Gabby's numbers were dropping. I needed information fast and the response here was quicker than what I would have gotten anywhere else. If you feel like someone is "telling" you what to do and you don't understand why, ask for an explanation. No one will be offended. There are some very experienced people here and some who have much less experience. If you find that someone has a good grasp on your cat's situation, it's fine to tag the person or send a private message. We typically will respond to a private message in your thread so everyone has access to the information.

    It will not be unusual if you find there's a discrepancy between what we say versus some of the information you hear from your vet. Vets get surprisingly little information about diabetes during their training and that information extends across species. It's also surprising at this point that many vets treat Lantus like previous generations of insulin. It's very different type of insulin from a pharmacological perspective.

     
  10. bxkitty

    bxkitty Member

    Joined:
    Oct 23, 2018
    I tried seeing about getting insulin syringes with 1/2 units on them, but I can't seem to find a pharmacy near by that has them...but I found this on Chewy and since I'm so green when it comes to medical stuff & supplies, does anyone know if this might work for me?

    https://www.chewy.com/insulin-syringesneedles-u-100-29/dp/173572

    So far I've been skipping Sophia's AM shot because of her numbers, but then have given it to her in the PM - again because of her numbers - and I'm thinking maybe she would do well with getting a .5unit instead of the 1unit dosage she's getting now? I mean, isn't it good to be consistent with dosing (AM & PM shots daily) that helps cats get closer to potentially reaching remission? (again; still trying to learn how all this stuff is supposed to work or hopefully pan out)
     
  11. Manu & Porto

    Manu & Porto Member

    Joined:
    Apr 14, 2018
  12. bxkitty

    bxkitty Member

    Joined:
    Oct 23, 2018
    @Manu & Porto Yeah, I can't quite tell from the picture myself, so I figured I'd ask. But thank you for that link! If I really can't find any .5unit marked ones locally, being able to use what I have def helps. So thank you for the link! :)
     
  13. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    They don't say they have half unit markings

    All these syringes have half unit markings (very important when you're doing microdosing) and are the correct syringes for U100 insulin and are available from ADW online:
    UtiCare
    Monoject
    Carepoint
    Sure Comfort
    B/D

    They're also available at WalMart if you have one near you. Their Relion brand 3/10ml, 31 gauge, 6mm insulin syringes come with half unit markings and are only $12.58 for a box of 100 (although a lot of them don't realize they DO come with half unit markings!)
     

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