10/23 Merlin AMPS 256, +2 315, PMPS 92

Last night he was low on his AM+11 at 156. I didn't give him his shot at his normal time because it was still low, but tested him at at what would have been his PMS+3 at 256, then at +5 it was 299. Gave him half his normal dose, and at PMS(normal time, not given time)+10 it was 347.

Geesh does that make sense?

Anyway, today we had:
AMPS: 256
AM+2: 315
PMPS: 92

He's very alert, active, feisty, affectionate and hungry as he just ate two cans of food! (Merrick's Cowboy Cookout and Nature's Variety Chicken and as he is underweight, I want him to gain weight.)) This is his first day off dry food completely.

Per vet instructions, she does not want him to receive his shot if he's very under 300. Because I'd been watching his BG, I felt comfortable enough to give him his AM shot knowing that his BG was going to go up (maybe know isn't the right word here, but I felt like looking at his numbers, knowing when he'd been dosed and what dose he'd be given, they were going to climb). However, I'm going to be watching him again tonight, but won't give him his shot until/if his numbers call for it.

Keeping the paws crossed that they don't though! :lol:

Welcome to Lantus Land!

Question, was this morning's AM shot given 12 hours after last night's shot, or 7 hours after last night's shot?

It was given 7 hours after his half PM dose was given.

Hello there,
welcome to the Lantus Land forum.
Congratulations on the beginning of the wet food diet.

I would like to encourage you to read thru the following links (also seen up top with the "starred" icon, known as stickies)
Maybe print them out and show them to your vet if you like.

We highly encourage patience and dosing consistency.
Meaning, Lantus requires patience, and does work best on a regular 12/12 shooting schedule.

One of the important items with Lantus is the storage shed - AKA insulin depot. Please read about that in the link provided.

As well as, Lantus dosing is not based on pre-shot numbers, but rather what is happening at nadir/peak.
Check this link New To the Group (scroll down for the curve chart)
for an example of a typical curve chart and what you might expect to see during any given cycle.

Might the Protocol be something your vet and yourself can work with?
We've seen a lot of success here with this protocol, including for my own kitty.

Lantus & Levemir Tight Regulation Protocol
Insulin Depot AKA The Storage Shed
Data Ready to Shoot Low Numbers
Dealing With Low Pre-shots

Please let us know how we can help.

Diana:

To follow up on Libby's post, Lantus dosing is every 12 hours. It's a long acting insulin that, unlike other types of insulin, allows for overlap between doses. If you shoot off-schedule, it can create problems since you're going to get overlap where the peak of action will be. This could drive numbers dangerously low. Lantus peak, or nadir, is around hours 4 - 8 (generally the lowest point is around +6 but it varies from cat to cat). If you shot several hours late, that cycle is bringing numbers down and then overlapping with the next cycle more than it would if you were shooting 12 hours after your late dose. Since you did not wait 12 hours from the time you shot late, your next shot was 5 hours early. An early shot acts like a dose increase due to the way the insulin overlaps each cycle. (Geez, I hope that makes sense to you.)

What you ran into is the dilemma everyone faces if you have a pre-shot test that is too low to shoot. If you delay, your schedule needs to be able to accommodate changing your shot time so you stay on a 12 hour schedule.

Not giving a shot if a cat's blood glucose is under 300 is not typical. Many people will note that their vet doesn't want them to give a shot if their cat is at most, testing at 200, many may say 100 and the vast majority of vets don't even encourage people to home test. Frankly, I'm concerned at your vet's instructions. It could leave Merlin above renal threshold (the point at which glucose is spilling into urine and can have a negative effect on the kidneys) much of the time. Most of us aim to have our cats spending the majority of their time in normal BG ranges (i.e., 50 - 120).

In any event, I'd encourage you to take a look at the starred sticky notes at the top of the Board. There's a huge amount of information there. We have information on our dosing protocol -- the protocol we use has been published in a veterinary journal so it may be something you want to share with your vet, how to care for Lantus, key concepts like the depot or "shed," as well as how to do a curve, our slang, posting conventions, etc. Please let us know how we can help.

Man, sometimes I feel like I've got the newbie hat on. ohmygod_smile

Having read through that a third time, I apparently got something mixed up in my head. (You know how you read so much and so much more and sometimes you get things jumbled up? Yes.)

I know from home testing and curves that Merlin hits his Nadir around +6, and at +8 his BC starts to climb again.

Sienne - I think the reason why 300 was chosen was because during his initial diagnosis and his vet curve, he never got under 300. (ID was 375, AMPS on vet curve was 487 and +6 (nadir) was 305.)