? Lantus decrease from 2u to 1u

A

Ana-Maria

Member Since 2018
Hello again everyone,

My Mimo had quite an eventful weekend as on Saturday, after 2u Friday night and 2u Saturday morning, his lowest point was 103 at +11 while his pm preshot was +115. Fearing that shooting 2u would cause him a hypo, I only administered 1u Saturday night and boy Sunday morning Mimo bounced like hell with an am preshot of 479 and HI (over 600) at +1. Administered 2u Sunday morning with a nadir of 340 at +7 and a PMPS of 422. Gave 2u again Sunday night with a +5.5 of 360.

Then Monday morning wanted to give 2u again but unfortunately i think i gave a furshot or anyway, not the whole dose went into him as (what i believe) his nadir was of 342 +5. Monday night gave 2u and he responded well: pre-shot-420; +2-272; +7-138; +9-163; am pre-shot this morning 128 when i decided to skip the am dose as I left at 9 and came back at 15:30. I tested at +13 and he was 122 after eating purina dm canned. Tested when i got home and he was 384.

I am turning to you for advice. I was thinking to decrease his dose to 1u/twice daily as i believe 2u twice daily is a bit too much. What do you think? Should i continue with 2u or try the 1u for a while and see how he responds? His shot is due in 2.5 hours.
 
We really need to see a spreadsheet in order to give dosing advice. It’s helpful to link posts as I’m sure you were asked and answered lots of questions.

Here’s your first post. I’m going to read the condo.

http://www.felinediabetes.com/FDMB/...hange-after-4u-of-lantus.204681/#post-2270242

Okay. I’m not sure anyone will feel comfortable giving dosing advice without seeing a spreadsheet. How about starting one and fill in just the last few days. You can go back and fill in the rest later if you want. Have you read the yellow stickies that explain the dosing approaches used here, SLGS and TR? You will find we increase and decrease at the beginning in .25 increments. Please consider reading your previous condo and all the advice given. Also add a signature. Which type of meter are you using? If feeding dry you would follow SLGS. Otherwise you have a choice but don’t need to make that right away. I’d love to help but need more info.
 
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also if you need help starting a ss there are people here that can get you up and running in no time.
 
Ana-Maria, can you create your signature so that Mimo's information is available with each of your posts please? I tried to look at the spreadsheet and I have "permission denied". You may need some help to get that adjusted so that we can see it.
Here is a link for the signature: SIGNATURE
When the spreadsheet link is fixed, you can copy that link and put it in your signature, that way all the information will be available with each of your posts.
I know it seems like a great deal to learn and do at first, it is. But we are right here with you and we will help.
@Marje and Gracie are you available to help with the spreadsheet right now?
 
Idjit's mom said:
Ana-Maria, can you create your signature so that Mimo's information is available with each of your posts please? I tried to look at the spreadsheet and I have "permission denied". You may need some help to get that adjusted so that we can see it.
Here is a link for the signature: SIGNATURE
When the spreadsheet link is fixed, you can copy that link and put it in your signature, that way all the information will be available with each of your posts.
I know it seems like a great deal to learn and do at first, it is. But we are right here with you and we will help.
@Marje and Gracie are you available to help with the spreadsheet right now?
Click to expand...

I think now should be visible. Please let me know if it works
 
Soo i gave him 1u tonight and will stick to it for 3 days just to see what it can do. I figured i'm better giving a safer dose knowing there will be no chance of skipping it than worrying that i shot a number with more than he needed. I'll update the ss and will keep everyone posted. PMPS 479 (think it's the goddamn hill's canned but my purina stock is empty and this is all i have until tomorrow evening.

So far he's been on lantus for a week and he's already seen doses of 3 and 4 that he did not have time to respond to and doses of 2 which turned out to be closer to what he needs but leaving me in a risky position to shoot below 130...i don't know if i made the right call tonight with the 1u but all i know is that i'm trying my best to help him. Other than that he kind of returned to his old self, meowing, giving himself baths, playing with plastic bags and shoe strings and wandering around the house. So this is on a more positive note that even though his numbers do not show it, there is an improvement in his attitude :)
 
I can see the ss. Well done. So now to see what is going on. You are just starting so we really don't know how Mimo is reacting yet. The 2 units you gave last night was still lowering the glucose this morning even with the skipped shot.

Ideally you want 2 shootable numbers every day. I err on the side of caution (except when it's me). Since the depot isn't quite established I would pretty much start over but at 1 unit every 12 hrs. Others please chime in.

And really try to keep it at 1 unit until the depot settles down in 6 cycles (3 days) if your not giving any dry food.

I saw on ss you gave some dry food, that will keep the glucose elevated. You can give freeze dried protein treats like PureBites if Mimo is dry food addict. They are treats not a replacement for food with proper nutrients.
 
Ana-Maria said:
Soo i gave him 1u tonight and will stick to it for 3 days just to see what it can do. I figured i'm better giving a safer dose knowing there will be no chance of skipping it than worrying that i shot a number with more than he needed. I'll update the ss and will keep everyone posted. PMPS 479 (think it's the goddamn hill's canned but my purina stock is empty and this is all i have until tomorrow evening.

So far he's been on lantus for a week and he's already seen doses of 3 and 4 that he did not have time to respond to and doses of 2 which turned out to be closer to what he needs but leaving me in a risky position to shoot below 130...i don't know if i made the right call tonight with the 1u but all i know is that i'm trying my best to help him. Other than that he kind of returned to his old self, meowing, giving himself baths, playing with plastic bags and shoe strings and wandering around the house. So this is on a more positive note that even though his numbers do not show it, there is an improvement in his attitude :)
Click to expand...

We crossed post. See mine above. I basically suggested the same.
 
Olive & Paula said:
I can see the ss. Well done. So now to see what is going on. You are just starting so we really don't know how Mimo is reacting yet. The 2 units you gave last night was still lowering the glucose this morning even with the skipped shot.

Ideally you want 2 shootable numbers every day. I err on the side of caution (except when it's me). Since the depot is quite established I would pretty much start over but at 1 unit every 12 hrs. Others please chime in.

And really try to keep it at 1 unit until the depot settles down in 6 cycles (3 days) if your not giving any dry food.

I saw on ss you gave some dry food, that will keep the glucose elevated. You can give freeze dried protein treats like PureBites if Mimo is dry food addict. They are treats not a replacement for food with proper nutrients.
Click to expand...

I was cautious this morning because i had classes from 9 to 15 and there was no one home to check his bg. If i were to stay home, i think i would've given him those 2 units this morning because i knew i was there to help if something were to happen.

Yes, i will stick to it for at least three days and see how he responds. I don't have high expectations though, his numbers are quite high and 1u seems a bit small to me. But then again i know nothing about FD.

I'll check to see if i can find PureBites here in Romania. Btw, is it ok if i feed him ocassionally some raw chicken breast? Or sour cream? As treats i mean.
 
On this forum, people use one of two dosing methods to help them decide what to do with the dose. Read over the Sticky Notes on the Tight Regulation protocol and Start Low Go Slow method, and see which one might suit you. For what it's worth, Mimo was starting to look good on 2.0 units. We don't reduce unless they go under 50 (according to TR) or 90 (according to SLGS), and he didn't go below 100 with a 2.0 unit dose. I would have kept the dose at 2.0 units. If you are really nervous, you could go back to 1.75 or 1.5 units, but 1.0 units is too much of a reduction. Which ever dose you choose, please hold it for six cycles in a row. We decide how to change doses based mainly on the lowest numbers at that dose, not the preshots, which tend to be the highest.

Raw chicken breast is fine for a treat, some people boil or bake them, but if he will eat raw, that's OK. The sour cream might not be a good choice. You might want to read the Sticky Note on Tight Regulation with a Full Time Job. Even if you don't ending up following TR, there are some good tips in there on how to keep him safe if you are gone for while during the day.
 
Great job getting the SS up and running! The next task is consistency in dose. I can see from your plan that you want to stick with the 1U. I hope that works well. Please keep in mind that the depot needs to form and stabilize, so you will not see immediate impact as you might expect from a drug. Remember, when we do make changes in dose we do in .25 increments because moving between whole units is too much. If you don't have U-100 syringes with 1/2 unit markings, you will want to use some other guide to help you consistently dose. Post more questions if you need help.

The data you are collecting is important - both numbers in the SS and also how he feels. We use the expression 5 P's around here because they are so much more than just their BG numbers. 5 Ps are purring, preening, playing, pooping, and peeing. Please continue to watch because his body will need time to adjust to these new lower numbers.

As you begin to fine tune things, others will ask you if about Mimo's weight (what is ideal weight and how is he now in terms of over / under weight). If he has any history of DKA please note that in your signature.
 
Wendy&Neko said:
On this forum, people use one of two dosing methods to help them decide what to do with the dose. Read over the Sticky Notes on the Tight Regulation protocol and Start Low Go Slow method, and see which one might suit you. For what it's worth, Mimo was starting to look good on 2.0 units. We don't reduce unless they go under 50 (according to TR) or 90 (according to SLGS), and he didn't go below 100 with a 2.0 unit dose. I would have kept the dose at 2.0 units. If you are really nervous, you could go back to 1.75 or 1.5 units, but 1.0 units is too much of a reduction. Which ever dose you choose, please hold it for six cycles in a row. We decide how to change doses based mainly on the lowest numbers at that dose, not the preshots, which tend to be the highest.

Raw chicken breast is fine for a treat, some people boil or bake them, but if he will eat raw, that's OK. The sour cream might not be a good choice. You might want to read the Sticky Note on Tight Regulation with a Full Time Job. Even if you don't ending up following TR, there are some good tips in there on how to keep him safe if you are gone for while during the day.
Click to expand...
Chances are we will go back to 2u after 6 cycles if the numbers won't go down too much. I will look for the suggeted syringes in the next few days because currently i'm using the lantus pen and cannot fine dose. I also believe a better dose would've been 1.5 but at the time being i do with what i have.

He loves it raw so yay on this! I read the TR protocol with full time job and the protocol itself and probably will go back to these notes for more than 100 times in the days to come.
 
Carol in Chicago said:
Great job getting the SS up and running! The next task is consistency in dose. I can see from your plan that you want to stick with the 1U. I hope that works well. Please keep in mind that the depot needs to form and stabilize, so you will not see immediate impact as you might expect from a drug. Remember, when we do make changes in dose we do in .25 increments because moving between whole units is too much. If you don't have U-100 syringes with 1/2 unit markings, you will want to use some other guide to help you consistently dose. Post more questions if you need help.

The data you are collecting is important - both numbers in the SS and also how he feels. We use the expression 5 P's around here because they are so much more than just their BG numbers. 5 Ps are purring, preening, playing, pooping, and peeing. Please continue to watch because his body will need time to adjust to these new lower numbers.

As you begin to fine tune things, others will ask you if about Mimo's weight (what is ideal weight and how is he now in terms of over / under weight). If he has any history of DKA please note that in your signature.
Click to expand...
I will stick to 1u until Friday see how it works. I also hope it'll work fine. For what it's worth, his weight now is ok i think. He was almost 7 kg when we diagnosed him and now he's down to 5.7 kg. No ketones or DKA on the last urine analysis a month ago. I looked for the ketostix in a pharmacy but couldn't find any. Will look more for them. Are there any signs that may signals ketones? Apart from him being in high numbers.
 
If you can't find 1/2 unit marked syringes there, some of our members have ordered them from England. If you are using the BD Microfine syringes, there is a paper attached to the Sticky Note on Tight Regulation, called Management of Diabetic Cats, that has a section on fine dosing. There is a link there to a paper ruler you can print out that you can use for those in between doses. And the third option is a digital caliper, such as is used in woodworking or metal working. This note on using calipers for dosing shows you how.

Danger signs for ketones are a fruity smelling breath. And if he's lethargic and not eating well and/or he has infection or inflammation.
 
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