Need Help with Dosing

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by KAC, Aug 1, 2020.

  1. KAC

    KAC New Member

    Joined:
    Jul 31, 2020
    My pumpkin is at 6 units twice a day. Numbers are still too high. Just got 361 this morning!!! The dose has been increased one unit at a time usually after 48 hrs on previous dose. Any advise is very welcome and needed. Seems like we are moving too fast......but haven't liked the 500 numbers.
    diagnosed 5/31/20
     
  2. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    I agree with Nan. We typically encourage caregivers to hold the dose a minimum of 3 days. The maximum dose increase if nadirs (lowest point in the cycle) is over 300 is 0.5u. This is a link to the two dosing methods we use. I'd encourage you to consider Tight Regulation since it's more aggressive and is more likely to get the numbers lower more quickly.

    Just to make sure, you aren't feeding any dry food? Your spreadsheet says Fancy Feast Classics. Please double check that all of the varieties you're using are low carb and Pumpkin isn't finding any contraband to snack on. (And remember, some treats are high carb.)
     
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  3. KAC

    KAC New Member

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    Jul 31, 2020
    Yes, he gets NO dry food. I used Dr. Pierson's list to pick the FF type. I'm staying away from those higher in Phosphorus (previous crystals). So far, I've only given him Chicken Feast and the Turkey/Giblets. No treats, no in between snacks. I'm like the food police. I even double check the floor for crumbs!! :joyful: He did manage to scavenge a small piece of raw bacon last week....didn't realize I had dropped it on floor and Super Pumpkin swept in for the steal!!!:cat: At least it was protein!!!
    Thank you for your advise. I love getting this info and encouragement. I'm not giving up!!!
     
  4. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    I'm tagging @Wendy&Neko.

    Once a kitty gets to a dose that's above 6u we often encourage you to get some additional labs to see whether or not your cat has a high dose condition -- notably either acromegaly or insulin resistance (insulin auto-antibodies). I'm on the fence since the doses were increased so quickly and by 1.0u. Wendy had considerable experience with these conditions and a good eye for whether the labs are a good idea.

    If you gave a shot this AM, could you enter the dose on your spreadsheet.(SS)?
     
  5. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Sep 21, 2018
  6. KAC

    KAC New Member

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    Jul 31, 2020
    I keep seeing (GA) what does this mean
     
  7. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

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    Mar 19, 2016
    GA="gone ahead" or "guardian angel". It's how we refer to our sugar kitties who have passed.
     
  8. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Hello and welcome. I too had a kitty who was a "big gulper". She needed more insulin due to have two secondary endocrine conditions, IAA (insulin auto antibodies) and acromegaly. Think of the former like the body reacting to the injected insulin like a foreign body or allergy. The antibodies grab onto the injected insulin and make it unavailable, until they die and release it. The latter is caused by a benign pituitary tumour that sends out excess growth hormone that ultimately causes the diabetes. One in four diabetic cats has acromegaly, though not all get to higher doses. However, once a cat gets to 6 units by safe increases, we suggest people test for those two conditions and the chances are one or the other is positive.

    That brings up the topic of how fast and how large the increases have been to date. So, let's start by hanging onto this 6 units dose at least six cycles (three days) and see what happens when the depot is full. Of course, if Pumpkin goes low we'd decrease. For this little experiment, I'd like you to get the preshot test and at least one other per cycle. You've been doing a good job of mostly doing that so far. Keep posting every day, and I'll try to keep an eye on you. If a kitty is over dosed, we should be able to see the results in those three days. If you need to increase, it would be by 0.5 units. Do you have 1/2 unit marked syringes?

    By the way, one of the reason his numbers seem higher than others is that you are using the AT, which reads higher in higher numbers. The majority of us use human meters which read lower at those high numbers.
     
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  9. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    One more thing I forgot to ask, are you checking regularly for urinary (or blood) ketones? When kitties are hanging out in high numbers, it's a good safety check.
     
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  10. KAC

    KAC New Member

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    Jul 31, 2020
    I haven't been checking the ketones but the vet has. He has no ketones. We are keeping a check on it. I don't do it because Pumpkin is shy when it comes to the litter box. I'm so confused, vet said to use the Alpha Trak, but it is about to break me with the cost of strips. I was about to buy another box at $50+ dollars. I'm wondering if I should use something else.
     
  11. KAC

    KAC New Member

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    Jul 31, 2020
    Thank you for the info. Please look at the SS today. I thought it was looking good, but then this morning.:( It was so high meter wouldn't read it. I'm just sitting here sobbing, I've totally lost it. Then I read the thread about drawing up the syringe.........and I may have contaminated my brand new bottle of insulin with silicon!!!!!!! What!!!! I'm just a basket case right now!!!
     
  12. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Sep 21, 2018
    @Wendy&Neko Hi Wendy do you think you could help Katrina out.
    Thank you
     
  13. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Sep 21, 2018
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  14. Panic

    Panic Well-Known Member

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    Apr 10, 2019
    It's okay Katrina, MANY cats get a HIGH reading at some point or another. On a human meter it just means "over 600" but not sure if it's the same on Alphatrak. He could just be bouncing from that yellow from last night he wasn't used to. It'll go back down. :)

    What happened that you think the bottle is contaminated?

    And for what it's worth, I would NOT buy another box of test strips for the Alphatrak, that meter will eat you out of house and home! Go to Walmart and pick up a Relion Prime meter, strips are only $18 for 100.
     
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  15. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012

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