Sander at too high insulin?

(Reposting here from the Lantus board)

Hi feline diabetes experts,

I am hoping some of your experience can help me figure out what is going on with my cat Sander. I have two brother cats who started Lantus 3 weeks ago at 2 units twice a day each. I can only test glucose levels sporadically (yes, I KNOW it is better to test more, but I'm doing my best). After some feedback from this list last week, and low AM glucose numbers, I have dropped the cats' doses .5 units at a time so that now they are on 1 unit twice a day. Tree seems to be doing just fine at this level. Sander for a few days earlier this week is still having AM numbers of 49 and 60, even with evening shots of only 1 unit. I skip the morning shot, his blood numbers seem to creep up to the 200's by evening, and then I give him 1 unit of insulin again. Does this suggest that Sander needs an even lower does? Do I drop the dose to .75 or .5 and see?

I understand that you determine doses by the BG numbers at the nadir, but I am a travelling performer and I have not been home to test him at the 6 hour mark during the day. I may have time this weekend to check at the 6 hour mark, but will be travelling for the next few days. What should my husband do for the interim while I am gone (he will not do blood tests)? What is the harm in just giving Sander 1.0 units of Lantus once a day? Or does it make sense to go down to .5 units twice a day while I am traveling?

Thanks for your help.

Elisa

I would agree with reducing the dose to 0.5 u until you can test +6 this weekend.

This should help give Blood sugar numbers at shot time that are more even --- instead of 49 and 200 -- maybe 100 and 100

It is highly probable that sometime during the night, Sander was lower than 49 -- this can be dangerous.

So ---- definitely reduce the dose some.

Just wondering, did you make a food change? If so, given Sanders numbers, it may be that he is heading for the falls (off insulin).

You can give .5 bid or you can give .25 twice a day. Once a day is not effective for 24 hours in cats. You end up with coverage for about 12 hours, and then they go up and up.

Hope this helps,

Claudia

Thanks, Phoebe and Claudia.

No recent diet change for Sander. Changed all cats to an all-canned low-carb Friskies diet in January. It would be awesome if Sander got OTJ.

Elisa

I would drop the dose down to .5u or .25u twice a day. If his preshot is that low, 1u is too much.

Normally I would say definitely .5u, but if no one will be testing .25u is safer. It might raise him a little while you're gone but if his need is that low it probably won't hurt much. But that's my guess...it's really hard to tell how much the cats need without testing.

Would it be possible to bribe your husband into doing tests? My boyfriend would not do them at first, and one day I came home and Bandit's PMPS was 49. I told my boyfriend that for every week he helped bloodtest, I would take him out to the restaurant of his choice as a treat. He immediately started getting a couple numbers during the day for me. When Bandit went to lower doses and I didn't need the afternoon numbers anymore, he would call me at work and ask if there was anything at all he could do for Bandit. :lol:

I don't even think he ever noticed that used the same method on him to get him to cooperate with bloodtesting that I did with Bandit.

Hi Elisa, and, of course, you two, maybe not so sweet Sander and sweet Tree,

How great is it that you're home testing?! Very!!!

As everyone has said, once a day shooting isn't the way to go. There's just not enough coverage for 24 hours... So, I humbly echo those who suggest reducing Sander's dose to 0.5 unit or even 0.25 unit twice a day... Perhaps going with 0.25 unit to re-start might be better, as it sounds like he doesn't need much... He could even end up being a 2-dose kitty, but it's best to be consistent until you get more information...

As for your DH (dear husband), I humbly suggest you either follow Julia's most interesting (and hilarious!) approach, or perhaps borrow Julia herself, as she seems to have a knack for behavior modification... ;o)

Welcome to the place you never wanted to be, dear Elisa; but, will be blessed for having found.

Encouraging hugs for you and your sweet furry boys,
Deb and Nikki -- and, Giz, forever dancing in my heart...

oh - I should have been more clear...

it would be better to give a smaller dose twice a day than a bigger dose once per day.