Day 5 on Lantus: Curious Numbers?

Discussion in 'Lantus / Levemir / Biosimilars' started by Harley Baby & Michele, Jul 15, 2018.

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  1. Harley Baby & Michele

    Harley Baby & Michele Member

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    Jun 3, 2018
    Hello! I thought we were going along nicely with the "depot filling" so to speak. Had terrific numbers yesterday then over 300 last night and today! Is this normal? I snuck the dose up 0.25 units this morning after 8 cycles. Harley looks well, no issues that I can see.
     
  2. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Sorry no one answered your question earlier, but you should have decreased the dose to 1.75 units, not increased this morning. You are following SLGS for dosing, because he is getting some dry food. The SLGS method says to reduce the dose if kitty goes below 90, which Harley did yesterday.

    Those high numbers last night were the result of a bounce, perfectly normal. From the New to the Group Sticky Note.
    • Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
     
  3. Harley Baby & Michele

    Harley Baby & Michele Member

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    Jun 3, 2018
    Thank you for your response. Actually I am following the TR Protocol. I updated my signature: he is NOT eating dry food. Harley has a history of DKA x 2. That is why I raised it 0.25 units this morning. Bouncing makes sense, although a bit confusing.

    Should I drop down to 2 units or continue at 2.25 units? He seems a bit more level today.

    His last reading was 236 at +9 hours. So starting to trend up again.

    Thank you!
     
  4. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    With TR, the initial dose is held 5-7 days to allow the depot to build. You only held for four. With a green, you hold longer - when you start to see nadirs under 100, hold for 10 cycles. I would go back to 2.0 units. Good to see those ketone tests.

    Thanks for updating the signature. I would also add his DKA date, as that impacts dosing suggestions.
     
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