Debating on increasing Lantus dose

Hi All - thanks in advance for reading through. We recently switched to Lantus from Novolin N and today was dose #6. We ran a curve today and it is doing a much gentler curve but we're still getting high numbers, the nadir was 364. He's currently on 0.5u and after reading the sticky on tight regulation, I'm debating about increasing him to 1.0u.

I know depot insulins take a bit to build (5-7) days but after reading the TR sticky, there is a line in there that if after 6 cycles we're still seeing high curve numbers to increase 0.5u. I'm currently working from home so I can test him as needed during the day until we fine tune the dose he needs. Not sure if I should stick to the current dose for 2 more days or try out the 1u.

Looking for thoughts based on his data.

 

Go ahead and increase to 1.0 units. 1.5 of Novolin got you to low blue, and we do take the dose of the previous insulin into consideration when switching.

Out of curiosity, how much does Diago weigh? Just wondering what his starting dose should have been if he had started back on Lantus.

 

He's right at 10lbs. The vet prescribed 1u but I know insulin can drop them quick so I took the safe route and only did 0.5u. I was thinking we'd be safe but I wasn't sure if the depot has to fill before we increase. I'm checking out the TR method and think I'm up for the challenge after careful consideration.

 

If you can swing TR, it is the best choice for a cat out of remission. You want to get him back regulated as quickly as possible and be a bit more aggressive (but safe). Per TR, his starting dose would have been 1 unit.

 

Ok, gave 1u for the PM dose. Fingers crossed this helps him. I'll be checking his BGs per the TR protocol. Thanks for checking out his SS.

 

@Wendy&Neko I need to add to my signature our current food, I posted in the main health forum and didn't realize that since we are on Dr. Elsey's chicken dry and Fancy Feast chicken pate that we shouldn't follow the TR method. I went ahead and gave 1u for the PM dose tonight and can hold it for x days to determine if we need an increase. Should I hold for 7 days unless he dips low?

 

I would stick with the 1.0 units - that's the starting dose on SLGS if you are feeding dry anyway. Any chance of getting rid of the dry? And yes, hold the dose for 7 days if following SLGS.

 

I've got three kitties and unfortunately my diabetic boy also has IBD, so he's so hard to completely transition. They all eat the dry but not so much of the wet. They struggle most days to eat 1/2 of a can of FF chicken once a day between the three of them. Thankfully with our current combo they all do really well, him especially with his IBD. Since he's on a little dry, should we only look at the SLGS method and forgo TR, unless we can get him to 100% wet food?

 

Low carb wet or raw is required for TR. It's much easier to find novel proteins with raw food, which makes it an option for IBD kitties. Raw Feeding for IBD Cats.

 

I'll check that out, thanks!

 

@Wendy&Neko, any chance you could take a quick look at our SS...switched to 1u 6 doses ago and his +4, +5 numbers are just crazy. What am I doing wrong?

 

@Panic you helped me on my other thread as well, do you mind taking a quick look. Am I worried about nothing.

 

Diago looks like he's bouncing. He could have dropped lower than we've seen (either during the night or earlier in the cycle when you didn't get any tests in) and that set his BG off. Do you know what bouncing is? I can give a description if you don't. Bounces can take up to 6 cycles to clear.

If Wendy doesn't have time to respond I would make a new thread for today - the L&L forum likes it if you make a new thread every day and link to the old one. Something like 9/10 Diago AMPS HI - Dosing Advice?

They might say to hold it until the bounce clears, or go ahead and increase.

 

Could you start getting a +2 for us, both morning and evening cycle? We do recommend at least a "before bed" test to make sure the kitty is going to be alright through the night. I think that will help you see if the numbers are staying high or dipping any.

 

@Panic thank you so much for looking at his ss. I was wondering what on earth is happening. I'm getting ready to grab a +5 to see if he's still decreasing or if he's on the way back up. I will absolutely get a +2 tonight and again in the AM. I'll give it until tonight after the +2 post PMPS to see what's happening and start a new thread if Wendy hasn't had a chance to peek too.

 

+5 decreased from 421 to 417. I'll grab a +6 too

 

+6 = 356

I hate starting with a HI for PS since I don't know just how high his number was to start. That definitely doesn't help see what's really going on.

 

+7 = 437