Numbers getting better. Time for a curve?

Sweet Tango

Sweet Tango

Member Since 2019
My Tango’s numbers have been looking a lot better over the last few days as I put a together a meal plan that seems to be working and maybe his body is starting to get used to the insulin Last night he was 211presot and this morning he was 160 preshot which is the lowest I’ve seen him since his diagnosis so I was super happy. I gave him .25 this morning. Was not able to trst midcycle. He’s die for his shot again in 3 hours. I guess it’s time for a curve? Anything else I need to be doing?
 
Are you giving a shot twice a day? If so, you need to put the amount in the PMPS column.

I can't stress enough how important spot check are. I'm concerned that Tango could drop to 30 and you wouldn't have a clue and we could suggest a dose increase. In deference to the safety of your Sweet Tango, I'm very reticent to make any suggestions about dose without more test data.
 
Are you giving insulin at night? I don't see anything in the units column for most of the last week. And have you been giving 0.05 units (not sure how you measure that!) or 0.5 units the last 4 mornings?

And yes, definitely time to get more mid cycle data, whether it be spot checks or a curve. Though it's best to do a curve after they have been on a given dose for a few days so the depot for that dose is stable. In the mean time, we determine how to change dose by the low points, so any spot check data you can get between shots will be helpful.

Here is the link to your last post here, included for continuity: http://www.felinediabetes.com/FDMB/threads/how-long-for-urine-amount-to-decrease.221548/
 
Yes. I give twice a day. The amps and the pmps numbers should be in there (except for two days that I wasn’t able to record them on the sheet) other than that they should all be there. I test before every shot. I have not done any midcycle testing or curves as of yet though.
 
There is no dose in the PMPS column from 11/9 to now. Can you please double check? Take a look by clicking on your spreadsheet from the link in your post above. Obviously, neither Wendy nor I can see at PM dose.

I'm putting on my moderator's hat and stepping up on a soapbox.
Lantus dosing is based on the lowest number in the cycle -- the nadir. Thus, it's critically important you get some tests beyond the pre-shot tests. The pre-shot tests tell you if it's safe to give an injection. That's all it tells you. It doesn't let you know if the nadir is high, low, or in-between. As an example, Gabby could start a cycle in the 400s, drop to the 40s my mid-cycle, and bounce back to the 400s by PMPS. If the only data I had was the pre-shot numbers, I would have increased her dose versus the data telling me she needed a dose reduction. In addition, if I hadn't been testing she could have sat in low numbers and possibly had hypoglycemic symptoms. The ONLY way you can keep Tango safe is to test. The only way the experienced members here can help you with questions about dosing is if we have data to base our decisions on.
Stepping off of the soapbox and putting the hat away.

In other words, please start getting at least one spot check each cycle. During the PM cycle, always get a before bed test so you can go to sleep knowing your kitty is safe.
 
Hi. If you look again, you will see that all the numbers are in there with the exception of 11/12, and 11/13. Other than that, all the amps and pmps shot numbers are recorded in the spreadsheet. I understand that it's time to do some midcycle and curve's which is what the title of my thread states.
 
Wendy&Neko said:
Are you giving insulin at night? I don't see anything in the units column for most of the last week. And have you been giving 0.05 units (not sure how you measure that!) or 0.5 units the last 4 mornings?

And yes, definitely time to get more mid cycle data, whether it be spot checks or a curve. Though it's best to do a curve after they have been on a given dose for a few days so the depot for that dose is stable. In the mean time, we determine how to change dose by the low points, so any spot check data you can get between shots will be helpful.

Here is the link to your last post here, included for continuity: http://www.felinediabetes.com/FDMB/threads/how-long-for-urine-amount-to-decrease.221548/
Click to expand...
I give .05 (1/2 unit) twice a day. This morning I gave him .25 (1 quarter unit).
 
Just to clarify, 0.05 is less insulin than 0.25u. Are you sure you don't mean 0.5u -- a half unit. Could you check this on your spreadsheet?
 
Good to know, but could you correct the entries in the spreadsheet then? Thanks. The spreadsheet is the first thing experienced members will look at.
 
Yes. The spreadsheet is updated. His numbers are starting to lower and I'm literally only giving him either half unit or quarter unit, so I can't get any lower of a dose than that. I will di a pmps in a couple hours before he eats, and then tomorrow I will do some midcycle testing. Just want to make sure I'm dosing him correctly.
 
Thanks!

With Lantus, the dose is based on the nadir. You don't change the dose unless numbers drop below either 90 if you are following the Start Low Go Slow method or below 50 if you are following the Tight Regulation Protocol. You will want to review the dosing methods sticky so you can decide on which approach you want to follow. Having a strategy will let you get the best experience with using Lantus.
 
Due to the fact that I'm so new to this, and paranoid about a hypo, I feel that the SLGS method may be best for me. My vet originally wanted me to give him 1 unit, but I said I wanted to start out at .5. So if the nadir is over 90, I should stay at my current dose?
 
First, please add the information about following SLGS to your signature. Otherwise, we'll all be pestering you and asking what method you're following since the decision making points are different for each approach.

With SLGS, these are the instructions regarding dose:
After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], do lengthen the waiting time between dose increases. If you decide to change another factor (e.g., diet or other medications), don't increase the insulin dose until the other change is complete (but decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change).
Click to expand...

You will have more information from getting a curve. We'll be happy to lend a hand once you have the numbers if you want confirmation about what to do. Being nervous about your cat dropping into low numbers is completely understandable. Getting more tests will give you greater confidence since you will have the data and can use food to move your cat into higher numbers if need be.
 
Ok. One last question. Obviously my cats ears are getting all beat up due to the testing. My Vet (and the Vet tech) also told me that they often test the cat on it's tail. I have never ever heard of this, but this Vet has been practicing for over 20 years, and she said they do it all the time. Is this a valid way of testing a cat?
 
Thanks for fixing the spreadsheet.:)

Sweet Tango said:
I feel that the SLGS method may be best for me.
Click to expand...
I agree, but for a different reason. Your profile post says you are still feeding dry food, some YA. TR requires feeding an all wet or raw food low carb diet. With SLGS, you hold the dose if you are seeing nadirs between 90 and 149. Unfortunately we don't have much in the way of nadir data so far, just the preshots. Nadirs are typically mid cycle with Lantus, but can vary quite a bit per cat and per cycle. But at this point, any checks in the middle of the cycle will be helpful. Don't forget those night time tests, many cats go lower at night.

Since you shot a lower dose this morning, the 0.5 unit depot will be depleted. Are you planning on going back to 0.5 units tonight? If so, I'd wait a couple more days before doing a curve. But if tomorrow is the one time you can do it, then I'd love to see more mid cycle data.

As for testing, we have heard of people using paw pads, but not tails. I think that would hurt more! Most cats I know would object to the tail pokes. Are you putting Neosporin on Tango's ears after the poke? That can help heal. Also make sure you put pressure on the poke site for 20 seconds, or however long he'll allow, to help limit bruising.
 
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