? How much should I lower the dose?

Hi! The numbers started to drop visibly for a few days. How much should I give them now? I can stay with him for 4 hours to test him, then he stays home alone until the evening. Thank you!!!

https://docs.google.com/spreadsheet...0KxSzPdZo5hdjzaF_XvpR0e1k/edit#gid=1976729166


The previous post:
https://www.felinediabetes.com/FDMB/threads/new-cat-with-diabetes-and-not-only-that.273745/

The instructions from the vet say to skip the dose!

Later edit: I give him 2U. I will feed him 2 times in the next hours. I hope it will be ok.

 

Sorry nobody was here to answer to you, this is not an emergency, please remove the 911.
I will tag @Bandit's Mom , maybe she is online to answer. I meanwhile can you please write what dosing method are you using? SLGS or TR?

 

Sorry I wasn't around. You shot a similar number last night. Lantus is very good at giving flat cycles when you shoot a lower preshots. If you take a look at his SS, he has dropped more with higher preshots than lower ones

If you can monitor, you can shoot any number over 90 with SLGS and over 50 with TR, with a human meter.

His numbers are looking great in the last few days!

 

Thank you very much for the answers. I already gave 2 U, it was 30 minutes past the normal time and I want to see what happens at least until 3+. I can ask someone to feed him one more time at +5 or +6 (but he doesn't know how to take a test).I have read a lot on this forum, unfortunately the information here conflicts with my recommendations from the vet. I was told to check the BG only before the injection (and clearly I only saw big numbers) - in addition, I have not seen anyone here vary daily, the dose depending on the BD before the shot.
Unfortunately, I did several investigations on the cat and they also found other diseases - it is infected with Toxoplasma (I can't figure out where, it doesn't come out at all), so today I start treatment with Zodon. His stomatitis doesn't go away, I switched to colloidal silver and colostrum and I hope it stays put for a little, while so I don't go back to corticosteroids now. He also has an incipient dilated cardiomyopathy... and some suspicious formations on the pancreas (I hope they are not malignant!).
His condition is generally good, he has no other symptoms, he no longer drinks water and urinates normally.
He's a little sleepy (I'm afraid it's from the medication for nephropathy that lowers blood pressure).
These are not easy days! And I have a lot of work at my job!

 

145 for 1.5 hours. If it's still like that, I'll be back at 2.5 U tonight.

 

Lantus is dosed based on how low it takes the dose and not based on preshots. Also it is a depot insulin so it works best when dosed consistently AM and PM. Even if you give a lower dose like you did this morning, the higher depot will continue to affect the first part of the cycle.

He may not have onset yet. Feed him a little and can you get another test at +3 or +4?

We can help you with dosing if you can select one one of the 2 dosing methods you follow. For the amount you test, you can follow TR. I would go back to 2.5U tonight unless he earns a reduction.

Sorry to hear he has so much going on! I am going to tag a few experienced members:

@Wendy&Neko
@Bron and Sheba (GA)

@audravincent 's Jinx has stomatitis and she had said something was working for him, but I don't remember what...

 

I’m so sorry Torky has so many health problems.
Clindamycin is the drug of choice for toxoplasmosis. Do you know why the vet gave you Zodon?
Toxoplasmosis can be caused by feeding raw meat that hasn’t been frozen for 3 days first, or eating infected rodents.

I have no experience with cats with heart issues but Wendy may be able to help you with that.

 

I will take a test before I leave home.
Yes, I think that TR fits better (I wrote in the spreadsheet).
The problem is that, if I have to go back to corticosteroids, the whole thing will be ruined!

 

Zodone contains Clindamycin (I can find it here - it's pills and he doesn't take tablets, I'll try to crush it and give it with a syringe dissolved in water).
For nephropathy he takes Semintra (telmisartan), and for cardiomyopathy Cardisure (Pimobendan).
and a ReConvalis Cardio supplement (with taurine, vitamins and carnitine).
If he has pancreatitis (?), I don't understand why there is no treatment for it... I will ask the vet.

 

The treatment for pancreatitis is supportive until it settles down. So you give pain medication for the pain as pancreatitis is painful, subQ fluids for dehydration and anti nausea medication for the nausea and/ or vomiting.

 

Yes, I saw this information here. But he doesn't seem to have any abdominal pain and no nausea at all - he eats everything he gets now!! He was always a bit dehydrated, he didn't drink water at all until he got diabetes - that's how I realized it. I always put water (quite a lot) in his food.

Tonight he has 131 at +10. Ate. He eats one more time before shooting. Should I return to 2.5 U?
Thank you!!

 

167 at +12. Should I return to 2.5 U or stay at 2U?

 

Hi, my boy has stomatitis and was on steroids for years. Once it got really bad he had dental surgery at his regular vet. That was a bad choice on my part because they left most of his tooth roots in. I then went to a veterinary specialist who removed his roots. He still has his canines and small front teeth. He's been on a low dose of atopica to keep it under control. Now he does good with a once a week dose but there were times when he had a flare up where he had a daily dose. The tooth removal really helped with his pain. I was worried about doing it but he's totally fine without teeth. I follow this group on facebook for advice https://www.facebook.com/groups/856632484350109

 

Sorry no-one got back to you. I'm not around at that time of day as I live in Australia and don't come online until later.
I can see you put the ? sign up on the subject line which is the correct thing to do.
You could try tagging either bandits mom or tiffmaxee or wendy & Neko.
Do you know how to tag? You type @ and then the user name of the person you want. A box will come up with options. Click on the option you want.

 

Yes, you are right, you are on the other side of the Earth!! I gave 2.5 U in the end, at +4 BG it is 134, so I think it's ok. He ate twice!

 

I'm glad you shot 2.5 units again. He hadn't earned a reduction from that dose. In fact, if following TR, it's time for an increase to 2.75 units. The goal is green nadirs.

I notice that your signature says he's getting prednisolone, but you said in the text above that you've stopped it? Has Torky seen a cardiologist vet? My girl had a heart condition where the cardio vet said she could not take prednisolone.

My Neko was also on pimobendan (Vetmedin) and it had no impact on her blood sugar numbers but made her heart much better.

 

Torky lost almost all his teeth (they fell out by themselves or due to scaling). It still has 3 canines and probably some roots.
It is not easy to find a specialist veterinary dentist here. In all of Bucharest (the capital) there is no special X-ray equipment for cats. I do regular X-rays that don't show much - he did an x-ray 2 weeks ago, and the result was: it might be, I'm not sure! So extractions are not an alternative. His stomatitis is predominantly caudal, the one that is resistant to FME or PME.

I bought ciclosporin to give him (equivalent to Atopica), but he tested positive for Toxoplasma and I can't use it.

 

His biggest problem is stomatitis - that's where everything comes from!
I went with him to 2 clinics in Bucharest (the capital) - we live in another city. There are 2 good clinics, but they don't have specialists - cardiologists or dentists.
Torky first of all needs something to control the stomatitis - if he gets into a bad phase he stops eating or drinking water and the end is clear.