4/12 Dante AMPS + 65, + 223 New member needs dosing advice

Discussion in 'Lantus / Levemir / Biosimilars' started by GA Carol & Dante, Apr 12, 2015.

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  1. GA Carol & Dante

    GA Carol & Dante Member

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    Apr 3, 2015
    Hello!
    I had been receiving wonderful support this morning when Dante's BG dropped to 65 at 8:22 am, 3 hours after his BG was 197 at 5:34 am and I administered his 2 units of Lantus. Through this forum and wonderful people, he is now showing a reading of 223!
    When I called the emergency hospital today, I was instructed to rub Karo syrup on his gums, monitor him all day, (also, I am in the middle of doing a BG curve, since he is not regulated yet) and skip the Lantus dosage of 2 units for tonight. Since he is at 225, of which I had been informed he would do so readily, (Thank you Elizabeth (!!), if he is consistent with his numbers, would I still give hims 2 units of Lantus tonight at 6 PM? Or do I listen to the emergency vet and skip the dosage? Thank you!
     
  2. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

    Joined:
    Feb 17, 2011
    Can you do a spreadsheet so we can see his blood sugar in context? It's important for us to know how long he's been on insulin, what dose, if he's had DKA or ketones, etc. Putting it on a spreadsheet lets us see things in context.

    Chances are good you'll give a shot tonight. On a Relion meter, 65 isn't a hypo and isn't even considered low numbers.

    How much does he weigh?
    Is he eating any dry food?
    Has he had either ketones or DKA?

    Would you post tonight when it's about 1/2 hr before his shot time and ask for help then? If you could get the spreadsheet going today that would help immensely. The information for doing that is here.

    and welcome to you and Dante! What's your name?
     
  3. GA Carol & Dante

    GA Carol & Dante Member

    Joined:
    Apr 3, 2015
    Julie, thank you for your repsonse, my name is Carol, hmm, maybe I should add that to Dante's name??!! Dante is aproximately 11 pounds, he was weighed 4 weeks ago at the vet and emergency room and has since gained a bit more and looks healthy now. He is eating Hounds and Gatos canned food (2 cans daily) and Science Diet dry (1/2 C every other day) . I am trying to wean him off the dry, so it is a slow pregression right now.

    I checked his ketones 2 days ago and there weren't any present.
    Yes, I will create a spreadsheet since I was just given a link this morning to create one. I have been on this forum since 8 am today due to his low number throwing me a curve that I wasn't ready for (!) and now that he has stabilized a bit, I need to run some quick errands. I will at least start the spreadsheet before 5;30 tonight as his next shot is due for 6:00pm. Yes, I will post and request help 1/2 hour in davnce of his schedule shot, THANK YOU SOOOO MUCH!!! Thank you for the warm welcome, this is such an incredible forum!!!
     
  4. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

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    Feb 17, 2011
    It is an amazing place here. :)

    check on CatInfo for 2 things - on the right side bar there is a link for transitioning dry food addicts to canned or raw food and there is a second link that goes to a list of food that has carb content of canned foods. Would you check and see what the carb content is of the Hounds and Gatos food?

    As long as there is any dry food in the picture you would use the dosing method called Start Low Go Slow. When/if the dry food gets out of the picture then you have the option of following that or the Tight Regulation Protocol.

    Some of us wrote a little blurb to help people start out - it's canned, but it's got what you need to know. :) here ya go:

    Welcome to Lantus and Lev land – the best place you probably never wanted to be! If you are like most of us, if this is your first few weeks of trying to wrap your head around the fact that your kitty has diabetes, you’ve no doubt been terrified, in tears, in a state of shock, and completely overwhelmed. Don’t worry. It gets easier. It really does.

    None of us here are veterinary professionals but many of us have been working with our cat’s diabetes for a long time. Even those of us who have been here for a short time are here to help. This is a wonderfully supportive community.

    There are a few first steps. We firmly believe that home testing is the best way to keep your cat safe. We keep a record of our cat’s blood glucose (BG) data on a spreadsheet (SS) which you can create using these instructions: http://www.felinediabetes.com/FDMB/...te-a-ss-and-link-it-in-your-signature.130337/. If you’ve not mastered home testing, we’re happy to offer suggestions or you may want to spend some time on the Health board mastering the basics of testing, low carb diet, and getting your SS set up. We’re happy to help you with those things, but you should be aware that this is a busy board and if there’s an emergency, everyone’s attention goes to helping the caregiver and his/her kitty.

    Once you’ve got a handle on the basics, you will have the option of following the Tight Regulation Protocol or the Start Low Go Slow (SLGS) method for managing your cat’s diabetes. You don’t have to stick with whichever approach you initially choose but it is helpful to give your choice a chance so you can evaluate the results fairly.

    The Tight Regulation protocol was developed based upon the premise that a cat's pancreas may be able to heal and return to producing insulin if the cat's BG is kept in a normal range (i.e., 50-120}. Caregivers following this protocol adjust insulin doses following the protocol guidelines to aim for that range. Basic information on the TR is here: http://www.felinediabetes.com/FDMB/threads/lantus-levemir-tight-regulation-protocol.1581/. The advantage of this approach is that it is based on research published in a leading veterinary journal and has an admirable track record of getting cats who are within the first year since diagnosis into remission.


    The Start Low Go Slow (SLGS) approach has caregivers start with an initial dose based upon the BG at diagnosis and whether kitty has been transitioned to a wet low carb diet, hold that dose for a week or two while testing for ketones regularly, being consistent with food and testing before shooting every 12 hours. Once a week a curve is done (test every 2 hours for one cycle) to check for the lowest point. the low number in that curve determines any dose change for the following week. This approach was the original method used in the FDMB prior to the TR protocol. It is an alternate approach if TR is not the right fit for you or your kitty. Basic information on the SLGS approach is here: http://www.felinediabetes.com/FDMB/threads/lantus-levemir-start-low-go-slow-method-slgs.129446/.


    Both approaches require that you test at pre-shot times and do your best to test at least once each 12-hour cycle. Lantus and Lev dosing is based on the lowest number in the cycle (i.e., the nadir) so getting at least one spot check is important to guide your dosing decisions.


    If you are switching to lantus or levemir from any other insulin, please post for suggestions on the starting dose before you change insulins. You should also get your vet’s recommendation.


    Amy&Trixie, Dyana&(GA)J.D., Julie&(GA) Punkin, Marje&Gracie, Sandy&Black Kitty, Sienne&Gabby, Wendy&Neko
     
  5. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    All the Hounds & Gato's are low carb....less than 10% (I know because we tried it but China didn't like the consistency) The highest is the beef at 9% but the other flavors are from 2% to 5%...which is perfect!
     
  6. Marycatmom

    Marycatmom Well-Known Member

    Joined:
    Oct 24, 2014
  7. GA Carol & Dante

    GA Carol & Dante Member

    Joined:
    Apr 3, 2015
    Wow, my head is spinning; so much information was received today, I don't know how to thank all of you!! Perhpas to the experienced ones, my issue may not have been a challenge but to me, today was Exhaaaaaaaaausting! There is absolutely NO WAY I could have done this without all of your support today.

    I chose Hounds and Gatos after eading they are completely natural without additives, by-product, artificial falvors and Carrageenan. I never heard of carrageenan until I came to this forum and then discovered the Rx diet prescribed for Dante had it lsited as the #2 ingredient. Carrageenan research unveiled a harsh study from a doctor : http://www.drweil.com/drw/u/QAA401181/Is-Carrageenan-Safe.html stating "that when laboratory mice are exposed to low concentrations of carrageenan for 18 days, they develop "profound" glucose intolerance and impaired insulin action, both of which can lead to diabetes." The very diet prescribed for a diabetic animal, when tested on lab rats actually induced diabetes, Seriously???, Ugh! So I promptly returned all the canned high protein foods that I had just bought, and exchanged them for Hounds and Cats in the Kitchen pouches.

    Julie, I have read the report from Dr. Lisa Pierson over and over, and still retain new information every time! Thank you for offering this link, as I found it on this forum several weeks ago when Dante ended up in the hospital. Please feel free to offer advice on Dante's SS as I hope I am doing correctly, any advice from anyone is gladly and graciously accepted on my part, so many, many thanks!

    I do have one more question though, I have to take Dante's BG one last time for the curve at 6:00 pm EST; however, should I take it before his dinner or after? I have been giving him a tablespoon of tuna after every BG, so he doesn't seem to be too hungry, (go figure!) so if I need to get his BG now, before dinner, it would be actually be possible (!)
     
  8. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    We want to get the Pre-shot tests done without the influence of food, so we suggest taking up food 2 hours before those Pre-shot tests.

    The other tests you get during the cycle don't matter as much if they've had food recently, but from +10 to PS, unless they're running below 50, we'd like them to go without food

    We generally Test/Feed/Shoot...all within about 5-10 minutes.
     
  9. Marycatmom

    Marycatmom Well-Known Member

    Joined:
    Oct 24, 2014
    You want to test, then feed, then shoot.
     
  10. Marycatmom

    Marycatmom Well-Known Member

    Joined:
    Oct 24, 2014
  11. GA Carol & Dante

    GA Carol & Dante Member

    Joined:
    Apr 3, 2015
    Try this, I changed it to share for everyone...
     
  12. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    Nope. You can't use "share". The instructions say to "publish to the web". I'll be happy to help you if you'd send me a PM. I can fix it for you in very short order :)
     
  13. GA Carol & Dante

    GA Carol & Dante Member

    Joined:
    Apr 3, 2015
    Marje;
    hmm, not quite sure how to send a private message through this forum???
     
  14. GA Carol & Dante

    GA Carol & Dante Member

    Joined:
    Apr 3, 2015
    Yes, I did select the 'publish to the web' oprion and since it was not visible, I changed it to 'share'...
     
  15. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

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    Feb 17, 2011
    Click on marje's profile picture, then choose "start a conversation. "
     
  16. GA Carol & Dante

    GA Carol & Dante Member

    Joined:
    Apr 3, 2015
    aha, that would be soooo much easier than what I just did, I found it by accident, now I hope I can retrieve her answer...thank you!
     
  17. GA Carol & Dante

    GA Carol & Dante Member

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    Apr 3, 2015
    Hmm, I redid the steps again, hopefully it will work now??
     
  18. GA Carol & Dante

    GA Carol & Dante Member

    Joined:
    Apr 3, 2015
    Hmm, with Dante's last reading, it was 181, before he ate his dinner, (Thank you for all of your prompt responses(!)), so I will skip the 2 unit dosage completely, unless otherwise advised... Unfortunately, I have to be somewhere right now, so I am going to sign off for now, Thank you again, for all of your help to everyone!!
     
  19. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    Got your message and I replied. I can fix this easy for you if you can follow the directions I sent in the PM. Thank you!!!
     
  20. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

    Joined:
    Feb 17, 2011
    Hi carol! Hey, love your new user name!:D

    Just fyi, with the 65 you got in your curve today, you would reduce Dante's dose by 0.25u. The Start Low Go Slow method calls for a dose reduction when he gets under 90.

    Lantus dosing is based upon how low the dose takes the cat.
     
  21. GA Carol & Dante

    GA Carol & Dante Member

    Joined:
    Apr 3, 2015
    Good Morning, Julie;

    Hah, at the emergency hospital for Dante, I didn't have a name, I was known as Dante's mom, so the name just naturally flowed here as well!

    Doggone it, (Haha, I can say that since this is a feline forum, though I LOVE dogs as well!) :), I should have opened my e-mail before I gave Dante his shot this am. I tested him and he was at 311, so I gave him his usual 2 units. I had skipoped his 2 units shot last night as he came in at 181. Also, I am using 3/10 30 gauge 8 mm syringes, should I be using something which shows a .25 mark, as this would be veeeeery difficult with this syringe?! I just bought another box of 100 of these, though I amsure I can return it, if necessary. I think I read somewhere yesterday about syringes, ugh, I received so much info I am still trying to wrap my brain around it all! Tonight, after work, I plan to re-read everything from the beginning and study all the links so graciously offered to me! Yes, I need to study the Start Low, Go Slow method, so thank you for advising me on this. I totally agree with you, I thought I needed to lower the daily dosage as well, but I didn't think you could lower by .25u, not on my syringe, that is...
     
  22. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    Not on any of our syringes. They don't make 0.25u marked syringes.....if you have 0.5u markings, that's the best you can do.

    Most of us Dose with Calipers. One more fun thing to learn :);)
     
  23. Linda and Scooter & Jack

    Linda and Scooter & Jack Well-Known Member

    Joined:
    Nov 9, 2012
    Hi Carol!
    Just wanted to welcome you both to the best place you never want to be in the world!
    You are in great hands and many kitties lives have been saved here.
     
  24. GA Carol & Dante

    GA Carol & Dante Member

    Joined:
    Apr 3, 2015
    Hello Linda!
    Thank you for the welcome! I like the logo, and unfortunately, understood it instantly when I read it the first time! I feel safe with Dante here in this forum, and that is a good feeling! Thank you and take care!
     
  25. GA Carol & Dante

    GA Carol & Dante Member

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    Apr 3, 2015
    Ugh, Marjorie;
    Another learning curve I will be doing, later though!!! :) Thank you for the link, hah, so much info her, thank you!
     
  26. GA Carol & Dante

    GA Carol & Dante Member

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    Apr 3, 2015
    Mary;
    Thank you for this: test, feed shoot, it has become a part of me now, and in the past few days, Dante is accepting it very willingly, (much to my surprise)! THANK you for all your help and supprot, you are all great people offering peace of mind in a crisis (for me that is), it is incredible, thank you! Sorry for the late reply, I woke up yesterday with a tremendous headache and had a tough time reading my computer at work, so I just needed down time last night, thank you! Enjoy your day!
     
  27. GA Carol & Dante

    GA Carol & Dante Member

    Joined:
    Apr 3, 2015
    Good Morning, Julie;

    Thank you for the advice, I am not able to reduce by .25...yet, right now, I am able to reduce by .50 much easier so I dropped it to 1.5 units this am, instead of the usual 2 units. Sorry for the late reply, I just needed some down time yesterday, as I woke up with a tremendous headache that wouldn't go away. Today I am fine! Whew, Thank you soooooo much for all of your support and help on Sunday, you are incredible with the amount of peace you offered me. Take care and enjoy your day!
     
  28. GA Carol & Dante

    GA Carol & Dante Member

    Joined:
    Apr 3, 2015
    Chris;
    I apologize for the insanely late response, my head was spinning on Sunday, and yesterday, I woke with a headache that refused to go away. Last night Dante and I needed some down time and it worked, today I am completely fine. Thank you for your assistance with the Hounds and Gatos question(!); however, may I ask which cat food you are feeding as it now seems that Dante does not want the Hounds and Gatos beef any more? ah, Yikes, I am sorry I need to go to work, I will check in after work tonight! THANK YOU !!!!
     
  29. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

    Joined:
    Feb 17, 2011
    Hi Carol,

    It may be too much to have lowered his dose by 0.5u. As crazy as it seems, most cats are extremely sensitive to even a slight dose change. The guidelines suggest changes in 0.25u increments most of the time - no syringe has those marked, but you can figure it out. Some people use reading glasses (which you can stack 2 pair on top of each other, or reading glasses on top of regular prescription glasses), or a magnifying lens, or even the optic visors that jewelers use. There are pictures in the New to the Group sticky that might be helpful (link below.)

    You'll know if it was too much of a dose reduction if he loses his blue and green numbers when you do the next curve, or in spot checks.

    Glad you're feeling better!

    Just a little housekeeping note - we ask everyone to start a new thread (condo) each day so they don't get too long. Then you can edit the subject line to add questions during that day. We link our previous threads so that the people who help can go back easily to look at previous discussions, too. If you need a hand figuring out how to do that, just say so. There's great info on all of this in the "New to the Group?" sticky.
     
  30. GA Carol & Dante

    GA Carol & Dante Member

    Joined:
    Apr 3, 2015
    Hello Julie;

    Wow, they are that sensitive??!! OK then, magnifying glass it is! Understood, I will check him tomorrow morning as he has been grazing on his dinner for the past 2 hours. Thank you!

    Ok, I will start a new thread every day, thank you for your patience! There is so much info on the New to the Group, and all the other links, this forum is like a treasure chest! Thank you for all of your advice, I will put Dante omn 1.75 units, thank you for your time in writing to me, it is so appreciated! Take care and good-night!
     
  31. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

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    Sure - hey no worries. It takes a while to learn all the little things. We all remember how overwhelming and intense it is when you're starting out.

    Sleep well!
     
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