can someone tell me if I'm following the guidelines for increasing dosage correctly? his numbers just aren't moving at all like they did with Vetsulin. Vetsulin (when I didn't do newbie things like readd insulin back in, or leave it out, or mess up the dosage) his numbers actually stayed pretty low, but were starting to climb. I'm on basaglar because it was given to me as a full new pen, I use the U100s, no half markings, but his numbers just seem to be staying high. I'm not sure if I'm doing something wrong, or too slow or what.
Hi Ashley, Are you following SLGS or TR? Your signature and SS say SLGS which means you hold the dose for 7 days then do a curve before increasing. Lantus is a depot insulin so it takes time for the depot to fill and to see the full potential of the dose. Vetsulin is an in and out insulin which drops the BB fast and the shoots back up high.
Here’s your previous dose for continuity. https://felinediabetes.com/FDMB/threads/climbing-numbers.243618/
i thought it said after 6 doses/3-4 days to slightly increase since it's a depot. so being that it's a depot hour long does it take to build up, because even at what 2 weeks he is still holding really high compared to his history or is the nadir more important? which even today after 3 hours ps, he was up i guess im just worried about staying too low for to long or if i just need to hold at 2u a few more days
Are you reading the SLGS method or the TR method.? Your signature and SS both say you are following SLGS. When you first start Lantus with SLGS you hold the starting dose for at least a week unless your kitty drops under 90. You need to be patient and wait for the depot to fill. Your SS looks like you are following the TR method. Even with that method, you hold the starting dose for at least 5 to 7 days. Wtih the SLGS method you hold each dose for a week and do a curve before increasing the dose if needed.
It his nadir that is important, you ignore the PS, and with few tests midcycle it is impossible to tell what his nadir is, so we don't know if it is safe to take the dose up or not. If you are doing TR and wanting to increase after 6 cycles, if you are not getting nadirs in the normal range, then you need to have the data to support that. That means getting some midcycle testing. Move the testing around so you start to get a picture of his patterns. (get a +2 +6 +9 one day, +3 +7 +10 another in the am cycle, move it around, and in the evening always at least get a before bed(my before bed test was a +5 so I would usually get a +2 +5 or sometimes +1 +3 +5) As Bron has said if you are doing slgs, you need to hold for a week. Run a curve at the end of the week and base your dosing decision on the nadirs, SLGS is a slower method, usually for cats that are still on dry food or for CG who are unable to monitor or don't feel comfortable with the more 'aggressive' dosing of TR. From your posts I can see you are anxious to get him into better numbers, if you are able to test more then try TR, if you have restrictions on when you are available to test, let us know and we can help you come up with a plan on testing so you would be able to follow TR if that is what you want to do.
okay that's definitely backwards of vetsulin, you have to watch the prenumbers to know whether to shoot or not. He is at 7 days on this, 14 doses and hasn't even come down a solid 50 points or out of the 400 range. I think I 'll try the TR next week when my babies are home and I can really watch him. I will check every few hours today to see what he is getting to. If I do TR would I try a slightly higher dose for a few days and test each day - I can look it up but I like communicating it helps me remember better.
If you are able to get some midcycle tests before you are ready to start increasing as you would with the TR, you could, if the numbers support it start with an increase from when you are starting that week at home. You would need to confirm in the 2 or three days prior that he is not seeing anything lower than those reds and pinks, by getting midcycle tests in both the am and pm cycle, a couple each cycle would be ideal. (by midcycle I mean anything between +1and +11, if you are able to mix it up) You haven't got a consecutive week (14 cycles on the 2u, otherwise you could have gone up as per SLGS to 2.25u) When are you thinking you will start TR?
I will try monday. I am concerned that all of the day time mid cycle readings are higher than preshot, there isn't any lower nadir except in the evening checks. I am worried that the batch I got is not good or maybe is ineffective for Tux. I know it has only been 2 weeks, so I'm trying to be patient. But it seems like if this is normal than it's just a very very very slow build from what it seems like. @Bron and Sheba (GA) @Gill & George
It does look like he needs more insulin. You will try start TR Monday? Can you just make sure you continue to get a couple of tests in the morning, and at least one at night, (better if you could get two could be a before bed and a +11 say) today tomorrow and sunday AM That would give you 6 consecutive cycles on the 2u, (everytime you skip or make a dose change you start counting cycles). You would then look back at he data you have collated friday through to sunday, and based on those numbers you will decide what the next step is (do post and ask for someone with experience to check your data with you, always good to do a double check with some experienced lantus users when first starting out with lantus) If you don't see anything better than yellow you would then take him up by 0.25 or 0.5u. If he sees blue or green you would continue to hold. How much or if you take him up or not will be based on the nadirs. From The dosing Sticky if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing. when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing. Increase by 0.25 unit after 3 days (6 consecutive cycles) if nadirs are greater than 200, but less than 300. Increase by 0.5 unit after 3 days (6 consecutive cycles) if nadirs are greater than 300. Are you still using the AT, or are you back on the relion?
