? 6/27 Nelson AMPS 353, +5 297, +9 306 staying too high

Can someone give advice on why Nelson is staying so high on 2 units of Lantus. He was super responsive to the insulin when we started now seems resistance. He was on the libre monitor for the 1st month so those numbers aren't included. Thanks

 

Hello and welcome to this forum. Make sure you read the yellow starred sticky notes on the top of this forum, including the one on dosing methods. People here pick one of two methods, which ever suits their lifestyle and goals for their cat. Based on the dosing method, we can help you better on dosing.

You seem to be missing a number of the PMPS tests. And early on were changing the doses a little faster than we would for the numbers you were seeing and now are holding quite long. Looks like you started out with just one dose a day? Can you tell me a bit about the decision making behind the earlier dose changes?

Lantus is a depot insulin, so you need to hold the dose at least six cycles for the depot to build and see what a dose can do. We also would be making changes by 0.25 units at once, no more, for the numbers you have been seeing.

 

Yes I've seen this exact post from you before. I am doing the best I can with testing. He has been on the same dose for over a week. He was so sensitive at the start of this ss that he was only once a day then we moved to half a unit twice a day. From there dosing has been getting constantly higher. I can't always measure a .25 or a .5 accurately with my needles and I'll have to wait to buy them from overseas. Again, doing the best I can and giving you all the info I have. I'm getting very upset at his lack of progress and I have been learning as much as I possibly can including reading all the info here.

 

Here are your last two posts for continuity Taz
http://www.felinediabetes.com/FDMB/threads/6-17-new-member-shot-getting-harder.231099/#post-2586474I
http://www.felinediabetes.com/FDMB/threads/ss-looks-different-than-what-i-see.231231/

Did you manage to get the syringes with the shorter needles from the chemist?
You were concerned in the last thread he still had a UTI, how is that now?

Did you read through the link I sent you about Aussie information and where to buy the 1/2 unit syringes in the UK?

Dont forget to Get some tests in during the pm cycle as well as the am cycle. A before bed test is a good idea.

 

Uti has cleared up. He's on 2 units a day for the last 8 days now, so needles irrelevant at moment. I have help to inject him now in morning and test when he lets me. I haven't messed up the pm shot.
I think I need someone to explain why the current info from the last fortnight is not enough to offer some advice. We got a new vial of lantus recently to rule that out. Sorry if I'm getting frustrated but why is the current info of no relevance.

 

I just want to cry. The vet is just going to increase his dose. I'm going to have to put the monitor back on.

 

Sorry we keep asking the same questions, but we want to make sure it's safe to increase before you do so. His daytime numbers look like he needs more insulin, but that's just half the story. My cat used to like to go low and night and bounce high during the day. Did it three months in a row. If I'd only looked at daytime data I would have increased, but she needed reductions instead. We look at how low the dose is taking the cat in determining how to change the dose.

 

Hi, I love Nelson's face, he looks so dignified.

We all understand how you feel. You want to cry, I have cried. We know how frustrated you are.

Do you dislike the monitor? Was it helpful when you had it before?

The night time tests are really important. A lot of cats drop lower at night. If you can get a +2 or +3 on most nights, you'll learn how he does at night. This helps you decide if it's safe to increase the dose.

Nelson wasn't diagnosed that long ago, he's ok. You have time to find the right dose for him. Giving shots and doing tests will get easier. Take a minute for yourself and tell yourself that you are doing a good job, and that Nelson is lucky to have you.

 

Good job getting some PM tests in!! I know Nelson is a handful but keep trying to always get at least the Pre-shot tests and at least 1 test somewhere mid-cycle on the AM cycle and those important "before bed" tests.

Going up to 2.25 makes sense. Are you getting more comfortable with the .25 unit doses? One thing you might want to do is use an old syringe and some kind of colored fluid and make yourself up a "sample" syringe. Decide where you want 2.25 to be and then when you're pulling up the actual insulin, you'll have something to compare to.

You'll want to hold the 2.25 dose for at least 6 cycles if you're doing TR or for 7 full days if you're doing SLGS.

Please try to post daily or every few days. Being an active participant on the board is the best way to get lots of people helping you. Read other people's posts....there's often questions that someone else thought to ask that you might not have even considered asking! There's lots to learn in other people's threads too!

When you have a few minutes to read (yeah, I know....who has extra time anymore?) there's some good pointers in this "Guide to posting and etiquette" as well as this "Making the most of your Lantus ISG experience"