Increased Dose

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by Giomax, Jan 13, 2019.

  1. Giomax

    Giomax Member

    Joined:
    Dec 29, 2018
    Max has been on 4 units (Lantus) twice daily for a couple weeks now and his numbers are constantly high no matter when I test him. Diabetic neuropathy is starting to set in, so I upped him to 5 units tonight. I plan on testing every two hours. First test had us down to 310! Normally we can't get anywhere below the 400s. This is the first real bit of progress we've made since he was diagnosed. He played with his brother a little bit tonight, he seems more alert already. Fingers crossed for us, please!
     
  2. Sue and Luci

    Sue and Luci Well-Known Member

    Joined:
    Nov 3, 2017
    Would you be able to share your Spreadsheet with us? (or if it's there, I don't see a link to it)...

    Congrats on seeing some early progress. It does take patience with Lantus.

    And a final thought - if you could please edit your title to say the date, cat's name, etc. - study the other posts for examples - but it would be something like this:
    1/13 Giomax AMPS ### - Increased Dose today - sorta like that. We'll be looking forward to your post tomorrow - hope to be able to view the SS as well - it'll help folks who are looking be able to understand his numbers and perhaps offer suggestions/advice.

    :bighug:
     
  3. Giomax

    Giomax Member

    Joined:
    Dec 29, 2018
    Am I supposed to make a new topic every day? I can't add to this one?
     
  4. Bron and Sheba

    Bron and Sheba Well-Known Member

    Joined:
    Feb 21, 2015
    You can keep posting on this thread until tomorrow then yes, on the Lantus page, we do a new post each day otherwise the posts get too long and for people giving advice it can be a lot to go through to get to the question. Also we link the previous days thread to the current thread for continuity. It means that someone helping can go back through the threads for information.
    Also we recommend increasing the dose by 0.25 units at a time. Increasing by whole units at a time is too much.
    Have you looked at whether you will follow either the Start Low Go Slow method or the Tight Regulation protocol? Both are at the top of the Lantus page in the yellow stickies.
    It would be helpful if you could set up a spreadsheet.
    Keep asking lots of questions.
     
  5. Giomax

    Giomax Member

    Joined:
    Dec 29, 2018
    I read the protocols. And I finally have my spreadsheet up! I work full time with no set schedule, so testing isn't as regulated as I'd like it to be, but I do what I can. I've been making no progress since diagnosis (his numbers were too high even before I started home testing). The only breakthrough I've had was yesterday evening when I put him up to 5 units and tested every two hours.
     
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  6. Bron and Sheba

    Bron and Sheba Well-Known Member

    Joined:
    Feb 21, 2015
    Hi,
    Just a couple of questions......
    What dose of insulin did Max start out with and how much did you increase by each time?

    Are you still feeding dry food? It is normally much higher in carbs than canned wet food so I would recommend you try swapping over to a low carb canned diet. You could well get much better blood sugar levels. BUT when you swap over you must be testing frequently as the blood sugars can drop significantly without the high carb dry. So I would do it slowly and when you are at home to test. You may need to reduce the dose as you swap over.

    Have you been testing for ketones in the urine? FD kitties can get ketones in the urine when they have high BSLs and are unregulated. This can lead to DKA which is a dangerous illness for cats. By testing for ketones you can catch any ketones early and get them treated. You just need to buy a bottle of Ketostix from the pharmacy, get a urine specimen from Max and test the urine as directed. It is easy and simple and very worth while.
    Keep asking questions. :)
    Bron
     
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  7. Wendy&Neko

    Wendy&Neko Well-Known Member

    Joined:
    Feb 28, 2012
    I am glad you finally saw some blue. That's great progress! :cool: And so is getting up that spreadsheet. :)

    There are a couple things you can do to help us help you better. First, make sure you get a test before each and every shot, to make sure it's safe to give insulin. Now that you have seen some good numbers, you never know when they'll show up. Neko surprised me a couple times with numbers in the 40's at shot time. :eek: Needless to say, I was glad I tested and waited for her numbers to come up before shooting.S

    Next, it'll be helpful if you pick one of our dosing methodologies, Tight Regulation protocol, or the Start Low Go Slow Method to follow for dosing. That'll help us help you with dosing suggestion. Just put either TR or SLGS in your signature so we know which one you have chosen. Regardless which method you pick, we hold each dose until either a reduction is earned, or we determine kitty needs a dose increase. Both of those decisions are based on how low the dose takes the cat, or the nadirs. We don't change the dose based on what the preshots look like. And both dosing methods also increase by smaller amounts than you have done. Have you got syringes with half units markings on them?
     
  8. Giomax

    Giomax Member

    Joined:
    Dec 29, 2018
    I do have half units on my syringes, but I'm happy with the numbers I'm seeing with 5 units. We started at 1 unit in October and when we weren't seeing results we increased by 1 unit about each month until we got to 4 units. Still terrible numbers with 4 units and neuropathy is setting in. Upped him to 5 units yesterday and numbers are better than I've seen since diagnosis.

    Max gets a low carb (about 13%), high protein dry food during the day called Instinct and canned Friskies in the evening.
     
  9. Wendy&Neko

    Wendy&Neko Well-Known Member

    Joined:
    Feb 28, 2012
    13% carbs is what we call medium carb. Low carb is under 10% carb. Will he not eat the Friskies pate wet food all the time?

    Looks like he’s bouncing in reaction to yesterday’s blues. Hopefully he will find those blues again soon.
     
  10. Giomax

    Giomax Member

    Joined:
    Dec 29, 2018
    I'm not home to give him small meals throughout the day, so I leave dry food out for them to munch on while I'm at work and overnight. I suppose I could do a can in the morning so they'll eat less of the dry throughout the day...but then I'll have to worry about his levels with the new 5 units. ;------;
     
  11. Bron and Sheba

    Bron and Sheba Well-Known Member

    Joined:
    Feb 21, 2015
    If you changed over to all low carb diet you would need to do it when you are around to test the BSLs and then adjust the insulin when the BSLs drop.
    How many cats do you have? And are any of them going to eat all the food at once or are they grazers?
    A few ways to manage food throughout the day .......
    You could buy a timed feeder that would open at set times to feed the cats.....you might need more than one feeder depending on the number of cats you have. .
    Or you could freeze the food and put it out on plates as you leave. As it thaws the kitties can eat it.
    There are some low carb dry options available...I'm not sure what they are as I am in Australia and have never used them but someone will be able to tell you what they are, I am sure.
     
  12. Giomax

    Giomax Member

    Joined:
    Dec 29, 2018
    I've heard Dr. Elsey's is good. I may order some of that. I have two cats and they both nibble on kibble throughout the day.
     
  13. Bron and Sheba

    Bron and Sheba Well-Known Member

    Joined:
    Feb 21, 2015
    I know that is low carb but I think I have heard that it can give some cats diarrhoea....but I might be mixing it up with another brand........try and check it out further.
     

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