Regulating Stu

Thanks to everyone who replied to my post about Stu's Lantus dose and scary BG numbers. Tomorrow I shall attempt to set up a spreadsheet and will also post the requested information about Stu, his diabetes history, health, etc. In the meantime, I have read all of the stickies again. This morning, even before I was able to get to reading the replies to my post of last night, I lowered Stu's dose to 4 units (down from the 4.5 units of the last three days). Today AMPS was 385. +6 was 248! I wonder what PMPS will be?! I intend to hold this 4-unit dose for a few days and see what happens. A question: the Lantus protocol for a cat who had previously been on a different insulin seems to suggest that the dosage of the other insulin should be taken into account when determining the Lantus dose. What factors does one take into account here? Stu had been on PZI Vet for 3 and 1/2 years before being switched to Lantus. His PZI dose when switched had been 5 units bid. Since I was not home-testing during those years, I only know what his BG numbers were at +5 (approximately) at the vet's: they were in the 120s to 130s (insulin was Idexx PZI Vet).
I am ready to get a handle on all of this and greatly appreciate your generous offers of help.

Ella (who is trying not to mangle Stu's ears!)

 

Hi Ella,
I didn't get a chance to say welcome yesterday.... so welcome to Lantus Land!
I'm not sure what factors are to be taken into consideration with respect to dosing when a cat was on a previous insulin, so from that aspect, I cannot help you.
What I can tell you, from 1st hand experience, is that lantus works totally different from PZI, so don't be surprise. Feel free to ask questions and people will answer you or point you in the right direction to get the answer.
As you have discovered already, this is a testing protocol.... but it's not something you can't do. YOU can do this and we will support you!

See you around!

 

ack, I typed a nice long reply, and the moment I hit Submit is the moment my internet decided to go off for a second and I lost it!

Anyway, I don't think I said welcome yet either, so welcome! We do try to consider the dose of the old insulin when we recommend a starting dose. However, Jojo is one of the people I trust most here, and if she says to start over then she is saying that because she has looked at all the details and thinks that is the safest way to go. Stu's safety is the first priority always. Jojo does have experience helping higher dose cats so she is not one of those who will yell "start over at 1 unit" without considering all the factors. That's just my opinion, of course. :smile:

Until you get your spreadsheet going, can you please put whatever numbers you have from the last several days into a format like this:

1/24
AMPS 385 (4 units)
+6 ~ 248
PMPS xxx etc....

That will help tremendously until the spreadsheet is ready. With Lantus, we always need to look at trends over several cycles instead of just one cycle at a time.

One thing we all try to do is to get a before bed test every night. That just means to test right before you fall into bed, whatever + hour that might be. Lots of Lantus cats have more action at night than during the day, and the fact that Stu was at 63 yesterday leaves some concern about how low he might have been going at night. Low numbers at night can also explain the high numbers he has been getting in the morning (he might be going low at night, then bouncing to a high number by AMPS, and repeating that cycle over and over again).

If you'll post every day, we'll help you get Stu straightened out safely. :smile:

Welcome!