11/08 First BG Curve on Lantus

Lots of good data today! For future reference, a curve is a test once every 2 hours for 12 hours, or every 3 hours for 18 hours. Not that we say no to more data.

You still have a few more days on 1 unit to build the depot, and hopefully the numbers get even better then.
 
Wendy&Neko said:
a curve is a test once every 2 hours for 12 hours, or every 3 hours for 18 hours. Not that we say no to more data.
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Thanks. I wanted to catch nadir, and I did!!!:) (Would have missed it at every 2 hours.) When Oliver was on Vetsulin I was encouraged to find nadir but didn't do such a great job. I wish I could have stayed up all night but got too tired.

The victory was short-lived however when Oliver got covered in a large, semi-soft poop pile--that I in my haste this morning to test/feed/shoot, left in the Breeze litter box for later. Stupidly, I picked him up, thinking I could help clean him, but immediately realized that I had no towel and he was covered in a lot more than just his paws. I had no choice but to release the angry boy (Oliver is a real neat freak) to spread it all over the house. (Reminder to self: buy disposable gloves!!! Why are you so cheap?!)
P.S. Now he thinks the litter box will do this to him again and is urinating outside the box!:banghead:
 
Question: since Oliver is new to Lantus, which BG's would be best for me to measure daily? I can do as many as are best. Advice much appreciated.
 
Hi! Have you had a chance to review the dosing methods - linked here? And a kitty's nadir can move around (because cats :p) so it's good to test at different times of the day. You'll start to notice Oliver's patterns after awhile.
  • On Tight Regulation, minimum testing is preshots and 1-2 other times during each cycle - more testing if kitty has a large drop or near the lower end of #s.
  • On SLGS, minimum testing is preshots and ideally a "before bed test" in the PM cycle. Again, more testing if kitty has a large drop or near the lower end of #s. SLGS calls for a full curve once a week to evaluate the dose.
I think I have the testing guidelines down but others may stop by too. Info on reducing and increasing the dose is in that link above.

Hope that helps :bighug:
 
Update: vet called and asked me to keep tracking the nadir. She said in the next day or two she wants to up his dose to 1.5 if the numbers don't improve.
 
Cat Caregiver said:
She said in the next day or two she wants to up his dose to 1.5 if the numbers don't improve.
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I have a couple of comments here. First, it takes 5-7 days of Lantus for the depot to build when you start it. And that's 5-7 days of two full shots (no fur shots) 12 hours apart. You still have a few days before the depot is full, so it's expected the numbers could be higher in the beginning. And see how today is better than yesterday, and that's only 5 cycles into consistent dosing.

Also, regardless of which dosing method you decide works for you, with the lovely blue yesterday, you'd only increase by 0.25 units at a time.
 
Wendy&Neko said:
Also, regardless of which dosing method you decide works for you, with the lovely blue yesterday, you'd only increase by 0.25 units at a time.
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I was a bit shocked that the vet suggested going up by 0.5. I will point out to her that Oliver already tried a 0.5 jump up on Vetsulin and 0.25 would have been better.

Maybe he will do even better since I watched the excellent video on this website showing how to draw up a syringe of Lantus. I am now pulling out a bit more than I need and squirting it in the air to get rid of the air bubble and stopping at the right dose. I think I had air bubble before. (I did that with Vetsulin too :banghead:. Too soon old, too late smart.)

Also, I agree that he needs more time. Today was the first day that he slept thru the dreaded 2-Hour-No-Food time before shooting. After test/feed/shoot he went back to sleep also. He's so cute sitting next to me on the floor with both paws crossed over his eyes: cat sleeping mask:cat:.
 
Wendy&Neko said:
First, it takes 5-7 days of Lantus for the depot to build when you start it. And that's 5-7 days of two full shots (no fur shots) 12 hours apart. You still have a few days before the depot is full,
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Since Oliver is switching from Vetsulin to Lantus, and his nadirs are >100 mg/dL (on both Vetsulin & Lantus), and he had ketones in his blood when Lantus was started: shouldn't his dose be raised earlier? I'm going by pg. 261, from the Roomp & Rand article* and quoted here:

"Care should, therefore, also be taken when switching a cat from a more potent (NPH or porcine lente insulin) to a less potent insulin (glargine or detemir) to avoid the development of ketosis. For example, if the cat typically has hyperglycemia and nadir glucose concentrations are 100 mg/dL (5.5 mmol/L) or more, with porcine lente insulin, an equivalent dose of glargine or detemir should be given and increased within 24 to 48 hours if needed."

*file:///C:/Users/restr/AppData/Local/Temp/management%20of%20diabetic%20cats.pdf
Also please note that Oliver was given a fast-acting insulin via IV on Nov. 5 which would have affected those numbers.

Maybe the vet is correct in her haste to raise Oliver to 1.5 units Lantus?
 
I'm going to suggest the same thing as Nan did on your post on the Health forum: https://felinediabetes.com/FDMB/threads/increase-dose-after-6-days-on-lantus.238425/ a 0.25 unit increase. I wasn't considering November 5th fast acting insulin in that suggestion, but rather the wonky dosing (skips, delays). Here's a post on Counting Cycles.

And a couple other suggestions. On this forum, we request that you do a new post each day that you post. When people see a post with a date from 3 days ago, they are less likely to respond. Making the Most of Your Lantus, Basaglar, & Levemir ISG Experience

If Oliver is ketone prone, it might also be a good thing to list in the signature, so it's kept in mind when people help you. And lastly, your signature says Relion meter but your spreadsheet mentions AT with Petsure strips. :confused: Which meter are you using going ahead? Also not sure I'd trust another manufacturers claims of working with someone else's meter when it comes to the life of my cat.

I also noted you are using Fortiflora. Is that mostly as a flavour enticer? It's not the best probiotic by far. A good page on probiotics.
 
Thanks. I was unclear on whether Oliver matched the protocol advice to raise Lantus "within 24 to 48 hours". You advice is very much appreciated.
 
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