10/01 PURRFACE +2=282 +4=288

No AMPS. Was showing Donna how to test BG and the few test strips we had were contaminated. Vet wants us to go to 2U twice a day. The lowest number for PurrFace since on Lantus has been a 210 at +3 two days ago and yesterday a 218 at +3. The rest are mostly in high 200s. Should we increase his dose a bit ie. .25 or .50 or do we need to wait longer? He is acting more like he use to pre-diagnoses since on Lantus. Yesterday he jumped on "his" shelf in the screened porch. It's an eight foot jump with another shelf half way up. Also purring a lot and playing a little. Still has neuropathy. We're giving him 5mg of Mythl 12 a day. I hope I linked yesterday post correctly!
PurrFace's Condo

Re: 10/01 PURRFACE +1=282 +4=288

Hi.

I feel very strongly about increasing doses by only .25 unless you are getting positive ketone readings (and even then someone with a lot of experience might feel .25 is warranted after an analysis of your spreadsheet.) The reason is the possibility that you will miss the right dose for your cat by skipping the .25 increment in between if you increase by .5 units. If you do miss that dose, it may not be immediately apparent. Giving too little insulin can look the same as giving too much on the spreadsheet. This is why the protocol calls for increases of only .25 units. You can be (almost) sure that you have not missed the right dose, and you will feel more confident raising the dose again if you are still not getting good results.

Another problem with going off protocol is that the people who give the best dosing advice here are basing part of it on whether you have followed the protocol. It is more difficult for them to make a recommendation if you have gone off protocol. Some of them will recommend that you take the dose back down to the point at which you deviated from the protocol and then follow the protocol to get back to the dose you are currently using. Then, when they see the results they are more sure of the advice you need, and will make dose recommendations.

In any event, I would not under any circumstances, were this my cat, increase by an entire unit, not in a million years.

Dale; Thank you for the input. Based on PurrFace's SS do you think a dose increase of .25 is warranted and OK? The folks on this board have been so supportive and helpful and I want to follow the protocol. Thanks to FDMB I was able to get the vet to research Lantus and make the change so I consider any advise given by the members the way to go.

I wish I felt confident giving specific dose advice. I don't, but I'm sure someone will come along who does! I feel the same way about the advice on this board. Someday Lantus and Levemir will have been used long enough that word will get out to ALL the vets on how to dose it. Until then, thank God for FDMB!

Edited: Oh, and that is majorly good news that PurrFace jumped 8 feet! Wow! The Whole Cat Report should be very good indeed!

Just to clarify with respect to the size of a dose increase based on Dale's comment, if a cat's nadirs are largely over 300, it is within the protocol to increase the dose by 0.5u. If nadirs are mostly less than 300, then you increase by 0.25u. You hold the initial dose for 5 - 7 days. After that initial period where you are allowing additional time for the insulin depot to stabilize, doses are evaluated after 3 days (6 cycles) unless numbers drop below 50 which warrants a dose reduction.

So, the short answer is, yes, I'd increase the dose. HOWEVER, if you do not have strips, it is neither safe to increase nor is it safe to eliminate a pre-shot test. In other words, I hope you had a chance to get more strips.

Sienne & Gabby & Dale Thank you for your reply. I purchased a new supply of test strips immediately as well as a back up batch. We also put together a hypo kit as suggested on the board. It's really hard to accurately read a .25 increment on the 0.3ml syringes, even with the 1/2 unit markings. I believe if we draw the insulin to the 2U mark and then ""twist" the plunger until dose is at the 1.5 mark and then one more tweek to get to the 1.25 mark. I'm also going to try to manually mark several syringes at the 1.25 dose. Any othe suggestions would be appreciated. Thanks to all again. Oh, PurrFace made the 8 foot jump but in two tiers. The first ledge is an inch or so over 4 feet off the floor and from there he jumps up to the ledge that is 8 feet off the floor. It's great to see him enjoying "his porch" and animal friends again.

Hello, and welcome to LL! Jane here.

Could we have a name to address you with, please? It's a bit awkward not to know who one's "talking" to, you know? :mrgreen:

Thanks!
Jane