Dosing questions/testing questions

Hi again - would someone please be able to take a look at Rex's spreadsheet and give me some advice/thoughts. His numbers seem to be fluctuating a bit the last few days. he will be up in the AM and then low (or in the normal range in the PM), then vice versa the next day. a few days ago he went 36 hours without a shot, then it was up in the 300's. so what I have been doing is when he is in the "normal" range, I don't give him a shot at all. Maybe that is not the correct thing to do. should I be giving a shot regardless of the numbers, just as long as he is not SUPER low? or should I be doing a reduced dose (which is what I do if he is just out of the normal range - say under 200), or just staying at the 2 units? actually what the vet had suggested last time we were there was 2 units in AM and 1 unit in PM. should I stick with that regardless of the numbers?? the only thing I have been doing really differently is I am giving him some different foods since he has diagnosed in august with CKD. so the foods I have been giving him are not by any means high in carbs, but a bit higher than what he was getting (under 5). now I am trying to stay under 10 and the protein is a bit lower - trying to stay in the 30's, maybe low 40's. any advice?

also, I was only testing in the PM because typically before his numbers were always lower in the PM and a bit higher in the AM (on the few occasions I had tested) and I figured that if I didn't give him a shot in the PM (if his numbers were low/normal), then by AM he would need one anyway. a few days ago his PM number was 94. so the next day I tested him in the AM and it was still in the normal range, so I didn't give a shot at all for 36 hours. then it went up to 300-something by PM. so, I started testing him in AM and PM every day since then. however, now he is getting stressed about that. if he even sees me get the treats out for testing, he tries to run the other way. I am giving hamburger - which he LOVES - so when he sees hamburger and still runs away - he is NOT happy. he has been trying to claw at me EVERY time I do the poke (sometimes I end up getting my own sample of blood.....). so, do I just have to make him deal with it, or does anyone have any other suggestions? and is the stress going to affect the numbers?

 

We always recommend dosing Lantus with consistency here - ie., giving the same dose AM and PM 12 hours apart unless a pre shot number is too low (50 on a human meter or 68 on a pet meter. With no data between doses it's impossible to know what's going on. Unfortunately testing is the only way to make good dosing decisions.

Here's how to approach finding the good dose range:

1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
2. test at least once near mid cycle or at bedtime daily to see how low the BG goes
3. do extra tests on days off to fill in the response picture
4. if indicated by consistently high numbers on your SS, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
5. post here for advice whenever you're confused or unsure of what to do.

I have no experience with CKD so can't advise.