2 weeks in, can I get a chart review?

Hi there,

Charlie (12 y/o) has been on Lantus for 2 weeks now. His numbers have improved greatly. Vet wanted to reduce his dose from 1 unit to .5 but had to compare my human meter to her pet meter side by side before deciding and I haven't heard back yet. Will follow up and see.

Anyway, he did have his first number in the 60s today. Can I get a couple people to look at his char so far and provide feedback. Please note he has been on wet food 2 meals a day (that's it) but he has now started getting a small snack of Dr. Elseys kibble as well.

Am I testing enough?
Am I tracking OK?
Are his numbers as good as I think they are?
would you agree with reducing to half unit?

Thank you!!

Chart is here
https://docs.google.com/spreadsheet...oRZc3t68Yye4_dggGig6Avt7gQY/edit?usp=drivesdk

Emma and Charlie

 

You're missing his entire PM cycle, so there's definitely room for improvement there
His numbers look amazing, from my perspective. But there's no reason to compare meters, the AT will read higher.

You need to feed more, and I don't see he's ready to reduce you're just getting the depot going..

@Bron and Sheba (GA) you here?

 

Hi Emma and Charlie
As Sasha said, you need to be testing in the Pm cycle as well, otherwise we can only see 1/2 the picture.
Cats often drop lower at night and unless you are testing you would have no idea.
Try and always get a before bed test in and if that test is lower than the preshot BG, set the alarm and get up a couple of hours later and test again.
Try and get at least one test in every cycle so we can see how Charlie is reacting to the insulin. Lantus is dosed on the nadir or lowest point in the cycle, not the preshot number, so getting those low numbers is really important.

As far as food goes, diabetic cats do much better with a main meal before the insulin dose and then a couple of snacks during the first half of both the cycles...am and pm cycles..
Feeding them only twice a day is old thinking and is not necessary with Lantus.

We have 2 dosing methods here. The Start Low Go Slow and the Tight Regulation.
You can’t be feeding any dry food if you are doing the TR so if we say you are doing SLGS (I will link the information to the dosing methods below), you reduce the dose if Charlie drops under 90.
We recommend reducing and increasing the dose in 1/4 unit increments so that you don’t go past the best dose and it is safe for Charlie.
So as Charlie has dropped under 90, I would reduce the dose to 0.75 units, which is half way between the 0.5 unit mark and the 1 unit Mark.
Link to dosing methods https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/

I am tagging @Bandit's Mom to have a look at the SS as I don’t think it is one of ours.

 

I will try to work on his night time readings (I knew I probably should but that's when I sleep LOL).

He was 88 this morning, he seems to keep creeping lower each day for pre-shots as well as nadir (based on limited curve data) and I know you don't adjust based on pre-shot, based on the nadir, but I don't have the syringes right now to do less than 1 unit, so I want to withhold the shot. Its his shot time now and I am supposed to be working. I will check back for a reply but he might just miss this dose.

Thank you!!!!!!!!

 

I think it would be wise to shoot twice a day, instead of giving two units at AMPS and one at PMPS. You're skipping a lot, so you mess up the depot..
I'm sleeping at night too, I set an alarm, test and back to bed
You still here, @Bron and Sheba (GA)

 

I'm not sure what you mean. I have only ever given 1 unit, 2x daily (1 unit 8:30AM, 1 unit 8:30PM). Today was the first missed shot. Am I missing something?
I agree on the nighttime, I will have to do that. If only testing once at night, what would be the best time? I understand it should be between +4 and +6 so is anytime in there OK? Same time each time? Every single night?

Thank you.

 

Thank you, this is VERY helpful, and I've taken notes. I'll have to start learning about SLGS and go get some needles that do less than 1 unit. I did get the google spreadsheet from someone who had shared theirs and I thought it was what everyone here uses but maybe not (at least those who are in US using a human meter).

 

Feed more and test PM cycle, got it Thank you!!!!

 

Hi Emma , you are dosing correctly I see 1 unit in the AM and 1 unit in the PM
Since you are feeding some dry food you will follow SLGS
Bron posted the link above to read about.
I see Bron said since he dropped below 90 to reduce his dose to 0.75 units
Since you don't have syringes with half unit markings which makes it easier
You will have to eye ball the 0.75 units. It would be a little bit above the 1 unit mark
At night you can test @+3 , then @+6 if his +3 is lower than his PMPS you might have to test a little longer to make sure he's not dropping too low.
You can vary the test times
And we do test every single night

 

Emma can you set up your signature , it's at the end of everyone's posts
in gray. You can look at mine . I will give you the link on how to do itso we don't have to ask you the same questions over and over again

 

https://felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

Tells you how to set up your signature

 

I am tagging @Bandit's Mom to have a look at the SS as I don’t think it is one of ours.
Hi Bhooma Bron mentioned this above, could you take a look at it please
I asked Emma to set up her signature , I don't know if she will know
how to put her spreadsheet link under her signature
Her SS link is at the end of her post #1
Thank you Bhooma
@Bandit's Mom

 

You will need to
Buy the U100 3/10 ml 30 or 31 gauge 6 or 7 mm insulin syringes. With 1/2 unit markings.
It’s important you give a dose each 12 hours so buy the syringes ASAP
Don’t forget your dose is now 0.75 units

 

I don’t think @Bandit's Mom must have got the last tag. Bhooma could you look at the SS please. I don’t think it’s one of ours.

 

Some useful information for you Emma
https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

 

COOL thanks! Doing what I can a little at a time. I appreciate you!!!! (testing out my signature now)

 

Yes I can see your signature!
Did you give a shot last night? The square is blank.
Don’t leave it before getting the syringes I mentioned. The lower BGs at the moment are probably from the depot of the Lantus still influencing the cycles.
Are you testing for ketones in the urine with Ketostix?

 

Hi Bron, Diane, I didn't get yesterday's tag.

The SS does look like our format with a few rows added on top with diet and medicines etc. Does it not open properly on your devices?

 

Hi Bhooma yes I can open it, everything is good
Thanks/so much

 

Thanks Bhooma, I thought you must not have received the tags.
Yes I can see the SS. I thought it was unusual the way the way grid slips up under the top part.

 

He got his usual 1 unit last night. The blank was just an oopsie, fixed it. I went and got the syringes and he got .75 unit tonight. I am not currently testing for ketones. Is that related to ketoacidosis (DKA)? Beacuse he was not in DKA when diagnosed.

 

I was concerned you may have missed at least 2 doses of the insulin and when you skip doses it is always a good idea to test for ketones. That is why I asked. I’m glad you only missed one dose and now have the syringes and are giving 0.75 U