Summer 5 days on Lantus

[Summers Mom]

HI, my cat Summer has only been on insulin (lantus) .5 units 2 x day since sunday. I am using the TR protocol and have been reading as much as time will allow me. I noticed it mentions to test Am pre shot,+3,+6,+9 and Pm shot. I have been testing Am Pre shot, and several times a day as well as the Pm shot but. Is it going to matter that i havn't tested her exactly as it says on the +3,+6,+9 in between the Am pre shot and Pm shot? being i am a newbie, i can't really tell how she is doing with her numbers and if i need to do anything differently or not. Could someone please look at Summer's Spreadsheet and tell me what you think about her numbers and what i need to do if anything? And do i need to be checking for keytones and how often and what is the best way to do this? Thank you!

 

[Gill & George]

Hello and Welcome.

You are doing a great job with the tests, getting a good spread of times and always getting a test in the pm cycle.

It's nice she dipped into blue. on october 16 she may have gone a bit lower than that 191 @+6, I might have been tempted to have a cup of hot chocolate and grab a +7 to see if she was still dropping or if indeed she was on her way up. Although nadir (low point ) in the cycle is often around the +6 mark, other factors can influence when she has her low point in the cycle, FWIW George usually nadired at around +5, but he also nadired as early as +2 and as late as +12.5

So my only suggestion with regards to testing, is that if you catch her dropping like that in the future, grab an extra test to see if she's done dropping, there will come a point where she will surprise you by continuing to drop.

As this is your starting dose and you are seeing some blue (she is not high and flat), I would continue to hold the dose for 7 days, before reassessing. You may well need to take the dose up to 0.75u BID, but I don't see any reason to rush that at the moment.

GENERAL GUIDELINES:

• Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).
• Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).
• Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.

 

[Summers Mom]

Hello and Welcome.

You are doing a great job with the tests, getting a good spread of times and always getting a test in the pm cycle.

It's nice she dipped into blue. on october 16 she may have gone a bit lower than that 191 @+6, I might have been tempted to have a cup of hot chocolate and grab a +7 to see if she was still dropping or if indeed she was on her way up. Although nadir (low point ) in the cycle is often around the +6 mark, other factors can influence when she has her low point in the cycle, FWIW George usually nadired at around +5, but he also nadired as early as +2 and as late as +12.5

So my only suggestion with regards to testing, is that if you catch her dropping like that in the future, grab an extra test to see if she's done dropping, there will come a point where she will surprise you by continuing to drop.

As this is your starting dose and you are seeing some blue (she is not high and flat), I would continue to hold the dose for 7 days, before reassessing. You may well need to take the dose up to 0.75u BID, but I don't see any reason to rush that at the moment.

GENERAL GUIDELINES:

• Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).
• Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).
• Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.

Thank you! And i will be sure to watch out for her low numbers and test some after that to see if she is still dropping. At what point do i need to test for keytones and how often and the easiest way?

 

[Stacy & Asia]

I'm very new to this, just to let you know. But you should be able to get Ketostix at almost any pharmacy (they may keep them behind the counter and you'd need to ask for them). You would need to hold the stick under the cat's urine, or find a way to dip in the cat's urine, and then read the results at a precise time (15 seconds) and compare the color to the color chart on the bottle. I test every couple of days if my kitty is in high numbers. I think urine keytones show up later than in the blood (about 5 days later, if I'm remembering correctly). They do make meters that will test blood glucose and use different strips to test keytones, but I don't know much about them.

 

[Wendy&Neko]

Hello and welcome. I haven't dropped in yet to say hello to you and your beautiful kitty.

It's always good to test for ketones when the numbers are higher, or if something is "off", like poor appetite or lethargy. Ketones do show up later in the urine than the blood, but it's hours, not days later.

 

[Bobbie And Bubba]

Hi there! Good job with all the testing. It is always a good idea to shake up the test, one day 3, 6, 9 another day 4, 7, 10, BUT, my favorite test is always the +2 because if it is the same as the pre shot or lower then it could indicate an active cycle and I would know to give a tsp or so of LC food to help her to surf and not drop so fast.

Toebeans talked about the ketone meters. I use the Precision Xtra one and the strips are pricey...... Usually we say to test when they are hanging out over 300's consistently. But, I do want to share my experience with you. Bubba was stuck in the yellows just like Summer. One of the mods on the board kept after me to test for ketones..... 'something isn't right'....... I did and he was throwing ketones. His history is that he had recently had his teeth cleaned and then 6 weeks later his right eye was removed due to cancer. Surgeries can throw them into ketones. So, I would go to the pharmacies and get the urine ketone strips ( I could never find him in the litter box so I went with the blood ketone meter) and test her just to take that off the table. She has hit a few blues but barely blues. I would feel more comfortable if you were to test her for ketones. And if negative, then you can proceed with raising her dose as per protocol.

 

[Summers Mom]

Hi there! Good job with all the testing. It is always a good idea to shake up the test, one day 3, 6, 9 another day 4, 7, 10, BUT, my favorite test is always the +2 because if it is the same as the pre shot or lower then it could indicate an active cycle and I would know to give a tsp or so of LC food to help her to surf and not drop so fast.

Toebeans talked about the ketone meters. I use the Precision Xtra one and the strips are pricey...... Usually we say to test when they are hanging out over 300's consistently. But, I do want to share my experience with you. Bubba was stuck in the yellows just like Summer. One of the mods on the board kept after me to test for ketones..... 'something isn't right'....... I did and he was throwing ketones. His history is that he had recently had his teeth cleaned and then 6 weeks later his right eye was removed due to cancer. Surgeries can throw them into ketones. So, I would go to the pharmacies and get the urine ketone strips ( I could never find him in the litter box so I went with the blood ketone meter) and test her just to take that off the table. She has hit a few blues but barely blues. I would feel more comfortable if you were to test her for ketones. And if negative, then you can proceed with raising her dose as per protocol.

I have the keytone strips already. I will try to catch her in the box as she is going. Thank you so much for sharing your story with me! I will let you know as soon as I get her keytones tested.

 

[Gill & George]

George wasn't shy about using the litter box, but I couldn't get the strip under his bottom, be ause he holds it too low. Someone here suggested using a large spoon or ladle.
So I waited for him to start peeing, and would scoot the large spoon under him to collect a sample to test, once he'd started peeing he wouldn't stop, though he would give me an indignant look.

 

[Bobbie And Bubba]

George wasn't shy about using the litter box, but I couldn't get the strip under his bottom, be ause he holds it too low. Someone here suggested using a large spoon or ladle.
So I waited for him to start peeing, and would scoot the large spoon under him to collect a sample to test, once he'd started peeing he wouldn't stop, though he would give me an indignant look.

I'm picture BFG with an indignant look on his face as he continued on.