Newbie needs dosing advice!

Unfortunately, I didn't catch this thread until this morning because my computer went kaput last night, but I hope someone can check out the end of this thread in Heath: http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=48046&p=522214#p522214

She has her spreadsheet up and running, and it seems the dose is definitely too high.

 

Julie, I did post on the Lantus board last week, but didn't get any replies. I thought I was continuing to post there, but somehow ended up on the main board again. There doesn't seem to be a link to the Lantus board on the home page, so I had to search through the general posts to find it. Sorry. I'll pay more attention in future. Thanks so much for your advice and help. We did give him 2.0 this morning, as his BG was back at 350. Does everyone else think that's too high a dose?

https://spreadsheets.google.com/spr...gVSWwdEp4OWZpVXZCd05WV0taYmJRb1JmVXc&hl=en_US

 

Welcome to lantus land. I looked at your ss and am confused on the dosing. I don't normally give dosing advice since I am still relatively new. Hopefully some of our more experienced members will be along soon.

I can tell you that you need to do some full curves and get some more spot checks. Since Lantus is based on nadir (the lowest point in the cycle), it is hard to tell how low Cinco is going. Nadir's can be at any point in the cycle. Many cats have nadir at +6, but it can change from day to day. It is really important to get a couple of days where you test every 2 hours to understand what is going on with Cinco overall.

Also, just so you know for future reference, we each post one condo a day. (A condo is the postings that you see.) It is structured as: 7/27 Cinco AMPS XXX. Then, if you have a question, just put it in the subject line after the other info. There are so many people posting on this site that it helps the ones who do give advice when they scan postings to see who needs help.

Again, welcome. This is a wonderful place full of really great people. I read your story about Cinco and what you have done is wonderful.

 

There is a link to all the boards from the main Board Index http://felinediabetes.com/FDMB/index.php If you are not logged in you will only see the public boards such as Health and the Insulin Support Groups. If you are logged in, then you will see all the boards available to members.

From the index, look for Insulin Support Groups (ISG). Then choose the Lantus (Glargine) board from the subforum list. You could also just click on Insulin Support Groups (ISG) and then on the next page choose Lantus (Glargine).

 

Hi Nemismom,
Welcome to Lantus Land. You will find the link to the Lantus group (if you haven't already found it) under Insulin Support Groups (ISG) Lantus (Glargine).

I am not expert at determining what dose you ought to be giving, but I can tell you that it does indeed look as if 2 units are too much. You cannot decide upon a dose by looking at the pre-shot number. Lantus dosing is based on the nadir (lowest number in the 12-hour cycle). Julie is right that the high numbers you have been seeing are "bounces" from the low numbers Cinco has been getting in mid cycles. His body is accustomed to high numbers and when you give too large a dose, the numbers plummet and his liver sees these low numbers and panics, sending glucose and other hormones into the bloodstream. Hence the bounce back to high numbers.

The informational "Stickeys" at the top of the Lantus forum are very informative. Start by reading "New to the Group" and "Tight Regulation Protocol". Once you get your kitty off dry food and onto low-carb wet food you may see a big drop in bg numbers. For this reason, you will have to monitor Cinco's blood glucose carefully to make sure you are not giving too much insulin. I hope that one of our experienced dosing people will be along later today to help you determine what your present dose should be. I think that if Cinco were my kitty, I would start over at 1 unit and see what happens. Follow the protocol ("Tight Regulation Protocol"), holding each dose for the required number of cycles unless the dose seems too high (then you should reduce immediately). It takes a while for a new dose to settle in. If it becomes apparent that 1 unit is too little, you can raise the dose. The purpose of following the protocol is to keep the kitty safe. If bg numbers are too high, it isn't great, but your kitty will be safe. If numbers are too low, it could be life-threatening.
So hang on and wait for some really experienced eyes to take a look at Cinco's spreadsheet.

Welcome!

Ella & Rusty

p.s. What is your name?

 

The 350 you're seeing is a bounce from the 39 you got last night. When a cat gets into hypoglycemic numbers, the hormone glucagon is secreted, which works exactly the opposite way insulin does by raising blood sugar. This is a survival mechanism to help the cat survive the hypoglycemia.

Again, I really think you need to lower the dose. Cinco has already gone too low on it and to continue at 2u is dangerous. Any number below 50 is an automatic decrease, and we also recommend that new kitties do not receive any insulin that has a pre-shot number below 200 until there is enough data to see how the insulin effects the kitty.

 

Also, check out this thread: http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207&start=0

It explains how to post your spreadsheet in your signature so that you don't have to keep pasting it in your messages, and it will show up automatically when you post.

 

hello and welcome to the group! good job getting a spreadsheet set up! :mrgreen:

it takes a little while to learn to navigate the board. it'll become second nature as time goes on. click here to view the replies to your post last week.

based on that 39 last night, cinco's dose should be reduced to 1.75u if you want to follow the Tight Regulation Protocol with Lantus or Levemir for Diabetic Cats. are you using syringes marked with half units? 1.75u can be measured by eye-balling half-way between the 1.5u line and the 2.0u line.

if you haven't had a chance to read through the "stickies" (informational posts marked with star icons at the top of the forum), please read through them at your earliest convenience. they contain tons of information... too much to be absorbed in one sitting. you'll find yourself referring to them often.

the learning curve is rather steep at the beginning, but you'll catch on in no time. ask whatever questions you may have. we'll do our best to get them answered. hope to see you posting often...

 

Hi again,
Do follow Jill's advice. She is one of the most experienced people here.
Good luck with your kitty,

Ella & Rusty