? 5/12 Mrs. Jones AMPS 396 +7 282 Nadir on Lantus?

Hello! Thanks again for helping me understand the bounce. We are moving to 288 and below again today. I think this is due in part to the wet food transition and clearing a bounce (was that the right term?). I am hoping we'll be fully on the Weruva by the end of the week but don't want to move too too fast as I don't want her to stop eating. As always, thanks for your support

Previous Post:

Hello and thanks for your reply. It seemed to be stubbornly high in the afternoon (late afternoon). Today's numbers are better. I did not feed her the Hill's today, just PowerCat kibble mixed with Weruva WX. I made a note on the spreadsheet now and updated my signature (yesterday). Do you think that integrating PowerCat and Weruva this week is the way to go? I don't feel good about the Hill's and Weruva Wx is apparently low carbs and ok for the kidneys due to Phos Focus. What do you think caused a bounce? Thank

1. https://docs.google.com/spreadsheet...3JynRDdhRNU1mI_oIHMoSaho7R5tpqfhRClxd/pubhtml
   Yesterday at 3:52 PMEditDeleteReport
   #5Reply
   
2. 
   Wendy&NekoModerator
   Joined:
   Feb 28, 2012
   Today was a bounce breaking cycle where the numbers came down to blues. Walk back 7 cycles and what do you see? Another blue, followed by 6 cycles of bounce. Bounces can take 6 cycles to resolve and numbers wobble around during those bounce cycles. The Hill's high carb food probably also contributed to higher numbers.
   
   A couple comments on the spreadsheet. First, you've done away with the row at top that has the +1, +2, etc. We all use that row to refer to times on the spreadsheet. Instead of actual clock times. As we are located all around the world we talk in +times. The reason I noticed that is I saw a 17.4 on your spreadsheet, that needs to be converted to 311. I think that's at +10 - but you made me count.
   
   The second reason for talking +times is if for some reason you have to change shot times, such as having to delay the shot for some reason. Then having the actual clock times becomes incorrect. We always talk number of hours since the shot.
   
   
   

 

No need to copy the content of your previous post - it's actually easier to figure out today vs yesterday if you don't. Just give a link to your last post, which is this: https://felinediabetes.com/FDMB/thr...-6-275-question-about-spike-yesterday.290229/

Slow and steady with the food change is a good idea.

Looks like possibly another bounce due to those blues last night. It happens.

 

Thanks for your reply. So just copy and paste the link in the browser bar? Ok, I'll give it a go tomorrow. Yes, I think if we can get fully on wet food next week, we'll all be feeling better

 

Hello again! I would like some guidance on understanding a Lantus nadir. Our current guidance is, if pre-food and insulin is more than 12 and the nadir is is equal or greater than 10, we increase. We maintain if pre-insulin in 10-12 and nadir is 4.95-8.8. We decrease is pre-insulin in less than 10 and nadir is 2.9-4.85. What are your thoughts? Thanks so much!

 

A nadir is the lowest value in the insulin cycle. Due to bouncing, we don't look at the low point in bounce cycles, but rather look to answer the question "how low does this dose take my cat?" So far the lowest 1.0 units has taken her lately is just above 150.

You'll probably get more help if you speak in terms of blood sugars in the US dg/ml numbers - as more people here are from the US.

Let me translate that. if pre-food and insulin is more than 216, and nadir is equal or greater than 180, we increase. We maintain if pre-insulin is 180-216 and nadir is 90-158. We decrease if pre-insulin is less than 160 and nadir is 52-90.

The above is not SLGS, which states. If nadirs are above 150 or above, you increase. If nadirs are 90-149, you maintain the dose. If nadirs are below 90, you reduce the dose. SLGS doses based on nadirs, not preshots.

If you want to follow your vet's guidance for dosing, please replace the SLGS in your signature and spreadsheet with "custom dosing" or "dosing per vet".

 

Thanks Wendy and Neko! This is super helpful and going forward I’ll use the US conversion numbers. In your opinion and based on your years of experience, what are your thoughts on custom dosing to support movement towards remission? Or is SLGS the way to go? Thanks so much!

 

To be truthful, we don't have any familiarity with what your vet is suggesting. It'll be extra work for us to help you with dosing. We don't care what the preshot values are, so it would be hard to incorporate that into our thinking. There is also a gap in the custom dosing, what do you do if the nadirs are in the 159-179 range? The maintain and decrease nadir actions aren't a lot different than SLGS, just a bit higher. The odds of remission are better if following Tight Regulation, but you can't do that with dry food in the picture. There are still some SLGS cats that go into remission, just not as many.

 

Thanks for your forthright reply. We will see how this week goes and then I will ask my vet about SLGS. I posted my numbers and with a question on the new thread (copying the link). I would hate to lose the support of this group. However, I think my vet is open and we could have a conversation. Thanks again!