a little dosing help is appreciated

hello,
schmit is having very high numbers (mostly in the 300's) regardless of his dose. we use lantus twice daily. he started on 1u in October. i upped it to 1.25u about 10 days ago. he had 1 good day with bg around 100-150 and then promptly went back up into the high 200's to top of the 300's.
we did an every 2-hour curve yesterday and the lowest he got was at the +12 mark with 286. so today i moved his dose to 1.5u
am i going too slow in changing his dose? i know lantus it is a 12hr medication and should be regulated rather than custom dosed. i don't want to toss his body into too much confusion, but i worry about what the elevated blood glucose is doing long-term. I've noticed the last 2 weeks he's peeing a lot more and while his behavior is much the same it is clear he's struggling a bit more than he has been.

-note-
he doesn't have a regular vet right now. he sees an urgent care vet. our dog's vet and the clinics in the area are not seeing new clients because of the pandemic.

also, we have another cat in the house who eats the same diet, but unlike schmit who will eat til he is full, waffle is a grazer who prefers to nosh a little, nap and come back for more in an hour or 2. we try to keep schmit from eating that food too, but sometimes he finishes his and a while later goes back to snack on the left-overs that Waffle hasn't gotten to yet.
in the morning i split a 5.5oz friskies seafood style pate for them and then for dinner they split another one but i also split a small can of fussie-cat wet food just to give them a little less-processed food in the mix. i leave the breakfast friskies out til about mid-day because waffle is such a slow eater, most of the time we put it up where schmit can't get to it and bring it down when waff decides he's hungry, but its not always feasible to cater to waffles gastric whims.

any advice on what i should be doing differently is much appreciated. thanks

 

Hi There!

I see some greens and blues so don’t be discouraged. The short answer is, yes but only because you’re following TR. It was hard for me at first too but with TR you should increase the dose every 3 days if you’re not seeing the results you want. You were right to up it to 1.5 and doing it at .25 units is also right. Just hang in there because feline diabetes is a marathon not s sprint!


Also with TR it’s important to always get at least 4 tests a day so make sure you’re getting the pmps and a +2 at least at night as well

 

I’d also try to get a later midday shot if you can. Like around +5,+6 since Lantus usually peaks around then

 

thank you so much! i will check his blood later in the day more and hopefully, with the 1.5 he won't need to be adjusted again for a while. it's been 3 months since schmit was diagnosed. it's still new to us. i worry about him constantly. having his total care under my control is terrifying. i appreciate all the encouragement and advice.

 

Hi Welcome! The Lantus Board is full of people using Lantus and some very helpful stickies at the top of the board - I'd stop by there if you haven't already and would encourage you to post there

Also, is there any way you can change your spreadsheet sharing to a webpage instead of a PDF? When you ask for any advice the first place anyone will look is your Spreadsheet and downloading it each time can be cumbersome. The SS instructions are here - link - if you need help, just ask and someone can help!

I can't really advise to dosing but like said above, you need to get test before every pre-shot to make sure it's safe to give insulin. Additionally, the +2 or +3 can be very insightful to a cycle:

• If the +2 is about the same as the Pre-shot, usually kitty is going to have a fairly "normal" cycle...slowly dropping to nadir and then slowly heading back up until the next PS
• If it's higher than the PS, it can indicate the beginning of a bounce and those are the cycles where you can usually get by without testing as much
• If the +2 is lower than the PS, that's your "early warning"....those are the cycles where it's important to try to get more tests in...but if you can't, you might want to leave some higher carb food down for kitty

Hope that helps some

 

thank you, that's good to know! i will look on the lantus page. i should have started there. also, about the pdf. i'll change that now.

 

He may need a few more adjustments but even after you think to yourself they settled on the right dose, things can change again which is why it’s important to keep testing. I agree with JaxBenji, the +2 is very helpful especially at night so you can have peace of mind going to sleep. The reason for the midday test is to try to get his nadir, lowest point in a 12-hour cycle, since we base all the dosing on that and not the preshot numbers. I also agree that the Lantus forum is extremely helpful and folks there are very knowledgeable, especially when you get an unusually low preshot number and need feedback on whether to shoot or not. With their help, I’ve shot Minnie’s regular dose even with a preshot lower than 80. Also, just want to make sure you know that on TR, you’ll only reduce the dose if you get a number lower than 50. It may be a while before you see that, but FYI.

Is Schmidt the back or the orange one? The black kitty is a carbon copy of my Bobo

 

my schmit. yay for black cats!

 

i'll look on the lantus forum. thank you all for the great advice!

 

Seconded!

Beautiful picture of a beautiful cat.


Mogs
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What a looker!!! I have a soft spot for black kitties

 

Here’s the link:

https://www.felinediabetes.com/FDMB/forums/lantus-basaglar-glargine-and-levemir-detemir.9/

and here’s my Bobo

 

He's lovely!


Mogs
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He’s a Velcro kitty and a total mama’s boy

 

what a majestic beast!