Amount of Lantus insulin?

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drjsiems

drjsiems

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I never thought I would be asking about LOW a.m. preshots, but Jake tested at 92 this morning which is good, but I am uncertain on how to proceed from here. His dosage was recently raised from 1 to 1-1/4U BID and his numbers have improved. But my vet tells me that no matter what, Jake should get at least some insulin BID to prevent the redvelopment of ketones - you may recall he has been recovering from DKA - even if it is just a "tick" of insulin when he is this low. So far, I have fed Jake about 1-1/2 ounces of food, but have done nothing else. It has been one hour since his 92 reading and his food intake. How much and when should I give him him his morning dose. Depending on that, I will know what to do with his evening dose. Jake has never been regulated - this may be the start of something good. Please advise!!!

Thanks,
Judy & Jake
 
hi there,

it's prob what - 2 hours since the 92? Have u retested? might be a good idea to grab some spotchecks this morning.
did u give any insulin?

Unfortunately, can't advise on dose, have you had a chance to set up a spreadsheet to record all your data?
viewtopic.php?f=6&t=16

do you have any other BG numbers from yesterday for example?

Hopefully someone with dosing experience can advise you today, but you will prob need to provide more data.
 
Have you tested again, since +12? His number after eating will be affected from the food spike, but what's done is done.
You can do what we call a BCS dose, a temporarily reduced dose, rather than skipping the insulin entirely. What plus number (how many hours after normal plus 12) is it now? Are you going to be home today to monitor him? Do you have HC food, karo, and plenty of test strips (just in case)?
 
Yes, I just tested Jake again at +14 - BG is now at 152 probably due to the 1-1/2 ounces (1/2 can Fancy Feast) he ate just 90 minutes ago. So I am inclined to not even give Jake the reduced dose you speak of since this is only 60 mg dl higher (probably from feeding). What do you think now? Skipping the shot does scare me as far as ketone redevelopment and what we recently went through (physically, emotionally, and monetarily), but he is still very low for getting any insulin.

Jake has only been at the 1-1/4 U BID dose for about four or five days (before that it was 1U BID for a couple of weeks - numbers were in the 500, 600, and yes, 700s a couple of time, but he was recovering from DKA). Yesterday, his numbers were AMPS = 435; mid day was 517 but I realized too late he had just eaten when I tested him, and 445 PMPS. These were a drastic improvement.

Yes, I will be here all day and have all of the stuff I need for just about any situation!

Thanks,
Judy & Jake
 
BUMP EYES PLEASE

hi Judy

can u edit your main subject line to read like this:
02/28 Jake +14/152 DKA history/DOSING HELP

have u been on a 12/12 dosing schedule?
did your vet advise on a safe dose?
 
DKA history/DOSING HELP NEEDED

I would do like Ronnie said, and change (Edit) the Subject in your first post to something like
02/28 Jake +14/152 DKA history/DOSING HELP
I think it is important for your cat to get some insulin, but I do not have the expertise to advise on dose, and I need to remind you that Lantus works on a 12/12 schedule. If you shoot a reduced dose, does your schedule allow you to shoot 12 hours after that for PMPS and 12 hours after that for AMPS? If not, ask, there are ways that we can help you to slowly get back on schedule.

I mainly just wanted to Bump up your post for more expert eyes......
 
Judy -

What would you feel comfortable shooting. I tend to agree that with this history some insulin would be helpful. Would you feel ok shooting 0.25 or 0.5 units? But, before you would consider shooting a lower number, do you have extra strips in the house and do you have high carb food? The latter may not be needed but in the off chance that numbers drop, you need to be prepared to manage lower numbers with high carb food.

I would really encourage you to put together as much information as you can on Jake's numbers. This forum is very numbers driven and it helps us enormously to have a spreadsheet to look at when trying to lend a hand with dosing. We are also used to managing lower numbers once there is data available in order to know, with some degree of certainty, what to expect.

How late are you with regard to your usual shot time?
 
Thanks, Ronnie, for linking the past threads, now I remember you!

Jake needs insulin. The DKA is too recent to take a chance on letting him develop ketones again. You're probably now several hours past your usual shot time. If you shot now, would you be able to shoot 12 hours after this tonight? What about tomorrow morning, do you have to get back on a particular schedule for work?

92 is a good number, but you're right, you don't have the data to be able to shoot at that number yet. The 152 is probably shootable, though, and I'm guessing he's even higher now. Can you get another test and then let us know what your schedule needs to be for the next few cycles? We need to get some insulin into him, even if it's not the full amount.
 
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