Advice Needed - Do I Increase Dose or Be Patient?

Hi there - pretty new to this and after doing what the vet initially suggested (one 3u dose a day) I switched Cole to 2u per dose, one in the AM and one in the PM. His numbers are all over the place - and I don't know if I need to be more patient, or should I increase him by .5u starting tonight.

I don't have lots of history yet to judge what the best choice is.

Advice would be appreciated!

thx Elizabeth

 

@tiffmaxee
@Wendy&Neko

 

I cant give dosing advice so I tried to tag some people for you.

 

I'm not a lantus user, but I know that there are links in the lantus section that have the dosing protocols spelled out. SO it would depend on if you are doing SLGS (start low go slow) or TR (tight regulation)... until a lantus person comes in to help you, read through the yellow stickies. https://www.felinediabetes.com/FDMB/forums/lantus-basaglar-glargine-and-levemir-detemir.9/

 

Thanks JanetNJ - appreciate the advice. I’ve tried reading a bunch on that forum today but not sure I understand it very well. I don’t think I could declare which protocol I’m on. Will go back and read some more!

 

Regardless of dosing method, I think you are safe to go to 2.25 units. The choice of dosing methods will tell you whether you can do it tonight, or wait another day. It looks like Cole is on 100% wet food, so it's up to you to decide which dosing method you want to chose. Tight Regulation requires at least 4 tests a day, the preshots, plus one AM and one PM, you can increase evert 3-5 days depending on nadirs, and on the flip side, kitty earns a reduction by going under 68 on the AT. With SLGS you hold each dose a week at least, test the two preshots and minimally a weekly curve (though more is better) and kitty earns a reduction by going under 90.

 

Thanks Wendy

 

Thank you - I think I’m starting to understand the difference in the methods and the frequency in testing. And I guess the major difference is how many days you hold at a given dose. Appreciate knowing that an increase could be ok in either case.

 

Thanks so much!

 

With SLGS, you increase if you aren't regularly seeing nadirs in the 90-149 range. With TR, you keep increasing until kitty gets regulated, or earns a reduction.

 

I have the time to do the tests for TR - is there an advantage to TR over SLGS?

 

TR gets you to regulation faster. The sooner a kitty gets to regulation after diagnosis, the better the chance for remission. We still do get cats on SLGS go into remission, but not as high a percent. So part of the decision has to be what your goals are for Cole, as well as what time you can commit. Some people have odd schedules or other committments that just don't allow the testing needed for TR. It's a more aggressive form of dosing, hence the need for increased numbers of tests for safety.

 

I would really hope for remission for him and working from home for the foreseeable future, I can manage the testing. Are changes always in .25 increments?

Thanks for your patience - I seem to only understand a small piece of information at a time

 

Regardless of the method, the change in dose is 0.25u. There are exceptions but it's best to think in terms of 0.25u increases or decreases.

 

At this point in Cole's journey, changes are by 0.25 units.

 

Got it! For now at least! Thanks

 

Thanks - that makes it clearer

 

Excellent! Now you have a plan going forward!! You are doing great and your kitty is lucky to have you.