Curve with Lantus - any different?

[RobinHarley]

My vet would like me to do a curve and I had a question...

I will be doing the curve on Wednesday, every 2 hours I will be testing. Is there a different between a 12 hour curve or a 24 hour curve? I am able to do either, is one better than the other (more informational)?

 

[tiffmaxee]

Why did your vet ask you not to give the morning shot? I don’t think that a curve after a skipped shot will be of any use as you have drained the depot. When following SLGS it’s suggested you do a curve once a week. Looking at your ss I think a 12 hour would be fine but not after a skipped shot .

 

[RobinHarley]

Why did your vet ask you not to give his morning shot? I don’t think that a curve after a skipped shot will be of any use as you have drained the depot. When following SLGS it’s suggested you do a curve once a week. Looking at your ss I think a 12 hour would be fine but not after a skipped shot .

Any time we see him for a diabetes appointment he never wants him to have his shot or breakfast... I don't understand why. He tells me to bring it and give it after the visit but I don't for the fact I give the shot at 7am and the appointment is at the earliest they can see someone, 8:15am. But he still tells me "oh no, it'll be fine" Even when I try explaining to him then his 7pm shot will act like a dose increase. He denies it. I am still working with this vet because he is willing to learn but this is still something I haven't gotten him to understand. This is the second time he has requested it. I will no longer be doing it, I will give him his food and shot. But also, hopefully we wont be having to see him anymore. I explained to him today that I wont be stopping anytime soon of home testing (he didn't want me home testing) so he seemed excited about that and told me I can email him from now on and do the curve myself. Also this is the only vet in my small town, nearest one (his old vet) is over an hour away.

(This vet has a history of going back and forth with being okay with stuff and then a few weeks later not okay, though when I put my foot down he has been good with that. Just waiting to move back to our old vet... but unable to make the drive right now as we moved a couple hours away but hoping in January / February we can make the transition back to her. I don't feel comfortable just yet managing this all on my own without vet check ins.)

 

[RobinHarley]

I don’t think that a curve after a skipped shot will be of any use as you have drained the depot.

I forgot to ask, then when would it be recommended to do one?

 

[tiffmaxee]

I forgot to ask, then when would it be recommended to do one?

I’d wait a week for the depot to build and follow SLGS. You test enough that you will know if one is needed sooner. Of course if you ever see a number under 90 you would decrease the dose and the seven day count starts over just like it does now since a shot was skipped.

I totally understand how you feel about not feeling comfortable managing on your own without vet input. Kudos to you for testing at home. When Max was diagnosed I wasn’t going to test myself. My vet had me come for nadir test a few times a week and one day had me do it. I had the monitor but was scared I would hurt Max. My vet was more conservative than the dosing here at first because of that. After I started home testing, folks here would suggest an increase sooner than my vet. I was hesitant to listen to them. Eventually I realized how knowledgeable they were and relied on them. Later I became one suggesting doses!

So one step at a time. While using this vet if you don’t agree with the advice after you email the ss, you can always say you are following his advice but do as you want. The same is true for ad ice given here. We don’t always agree and you hold the syringe. Often it’s a judgement call.

 

[Sue and Luci]

you can always say you are following his advice but do as you want.

Couldn't agree more! You'll get the hang of testing - the more you do it, the more patterns you'll see emerge and you'll know when your cat is going to go lower or go higher...those patterns tend to develop over time...and I agree with you @RobinHarley - Lantus is a consistency type of medication - give it every 12 hours (unless of course you're getting a low green number)...then read the stickey notes and follow the protocol...but that's the only time.

Best to you!

 

[RobinHarley]

Thank you @Sue and Luci and @tiffmaxee! That was all great advice I needed. I have started to notice little patterns start to emerge slowly... but I just don't know what they mean yet so I wait for the day that comes to light and I understand a bit more. Also thank you for the support - this is all such a wealth of knowledge that comes barreling down on you when you have a sugar kitty. Lots to learn, get use to, and take part of! Wouldn't change it for the world though, love this little booger.

 

[Wendy&Neko]

If following SLGS, you can do either a 12 hour curve (every 2 hours) or 18 hour curve (every 3 hours). There are pros and cons to both. A 12 hour curve gets more detail, an 18 hour curve gives you two cycles of data.

You've gotten enough data on this dose with spot checking (good job) and been on this dose 17 days, which is way longer than you should according to SLGS. I think you can increase to 1.75 units whenever it's convenient to you. You don't want to hold onto a dose too long that isn't getting him into good numbers, or his body will get used to higher numbers. It's called glucose toxicity, and basically means you might need to go higher in dose to get over it and start seeing normal numbers. Patterns will become more obvious when he starts seeing better numbers. Right now it's mostly high and flat.

If you want to wait until after the curve to increase, the depot should be built after 6 cycles, so you could curve on Thursday if that works for you.