? 6/29 Leon AMPS 115, +5 241, Lantus Efficacy or Resistance?

Just pulling my hair out with my poor guy.

I've been noticing that despite his steady dosage, his numbers seem to increase after eating, despite the dosage of Lantus.

If anyone could take a look at his spreadsheet, I'd be much obliged; its getting frustrating seeing his numbers all over the place; especially during his latest curve on 6/21.

I always test just before eating; and then usually give him his shot as he's about finished with his can of food (about 5-10 minutes later).

I just have a hard time understanding why his numbers generally go up during the curve, instead of down.

I just picked up a new vial of lantus; thinking perhaps the old one went bad (it was about 2.5 mos old), but that doesnt seem to help.


Any thoughts?
We are going on a 6 day vacation in about 10 days; and I was really hoping to get him more regulated as my brother and will be stopping by to take his readings and give him his shot and feed him; he wont have someone always around in case of a hypo event.

 

I have a couple of thoughts....

First, the closer you can get to shooting every 12 hours, the better. An early shot acts like a dose increase and a late shot acts like a dose reduction. You may be OK with up to a 30 minute window on shot times but if your cat is sensitive to these sorts of changes, it can result in less than ideal numbers since there is an effect of time on the depot.

The same is true with dosing. Lantus likes consistency. Doses need to be held for a minimum of 3 days if following TR and longer if following SLGS. Likewise, holding a dose overly long may not have a good effect if Leon's numbers aren't in the range you're hoping for. With both shot time and dose, the more your make changes, the more likely it is that the depot is disrupted and you see wonky numbers.

We encourage members to decide on a dosing strategy -- either the Tight Regulation Protocol or Start Low Go Slow. Both of these approaches are described in the notes at the top of the Board. Using a dosing method will provide you with parameters on when to increase or decrease your cat's dose.

Regarding the curve on 6/21, his numbers really aren't all over the place. In fact, they are relatively flat. It helps to remember that there is a 20% variability in any number that you get that is due to meter variance.

You may also find that Leon's numbers are a bit better if you give him several smaller meals a few times during the cycle versus one large meal at shot time.