1st dose - Is 2 units ok/low enough?

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Abby Normal

Member Since 2017
Hello Everyone!
New here with my 14 yr old cat, Molly, who was recently diagnosed.

I understand that no one here is a vet and every cat is different but I am curious if anyone knows if 2 units is not too high for 1st round of dosing? (considering the standard starting dose amount listed on here was 1 unit)

Molly's Stats:
*Weight - 5.27 kg
*Glucose - 406
*Feeding - She's a nibbler... almost never eats a large amount in one sitting. Even when she does it is never the full meal.

*Food
Current - Combo of canned and raw with a tiny amnt of her old dry as a treat while I'm transitioning her off of it. (she has maybe eaten 10-15 pieces in 1 day)

Past- was the same as above, she just ate less of the wet and more dry.

I have not rcvd the level of info and support I thought I would/should get from the vet and am very thankful I found this page.

Thank you for your time,
Abby
 
Hi, Abby--was Molly's initial glucose test before you changed her diet (reducing the dry food), or after? Will you be able to test her levels at home? (Most people here do--it's more feasible than it might sound!)
 
I would think it was too high, especially if your not testing a lot.

With the two protocols supported here:


SLGS (Start Low Go Slow)
from: http://www.felinediabetes.com/FDMB/threads/lantus-levemir-start-low-go-slow-method-slgs.129446/
Starting Dose:
  • 1u BID if kitty is not on a wet/canned low carb diet
  • 0.5u BID if kitty has been switched to a wet/canned low carb diet
  • If the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration
  • Generally, shots are to be given 12 hours apart.
TR ( Tight Regulation)
from: http://www.felinediabetes.com/FDMB/threads/lantus-levemir-tight-regulation-protocol-tr.1581/
STARTING DOSE:
The weight based formula for determining a starting dose of Lantus or Levemir when following the Tight Regulation Protocol:
  • the formula is 0.25 unit per kg of the cat's ideal weight
  • if kitty is underweight, the formula frequently used is 0.25 unit per kg of kitty's actual weight
  • if the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration
 
Hey Abby, below is the information for starting Lantus if you are following Tight Regulation.

STARTING DOSE: The weight based formula for determining a starting dose of Lantus or Levemir when following the Tight Regulation Protocol:
  • the formula is 0.25 unit per kg of the cat's ideal weight
  • if kitty is underweight, the formula frequently used is 0.25 unit per kg of kitty's actual weight
  • if the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration
And for following the Start Low Go Slow method (SLGS) :

Starting Dose:
  • 1u BID if kitty is not on a wet/canned low carb diet
  • 0.5u BID if kitty has been switched to a wet/canned low carb diet
  • If the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration
  • Generally, shots are to be given 12 hours apart.
Is she at her ideal weight? I think 2 units is too high to start. We usually start at .50 unit to 1 unit and hold that dose for one week to see how low it takes her. Of course if she goes too low, you would reduce it.

Will you be home testing? I can't stress enough the importance of doing that. Many of use human meters as both of the protocols/methods are designed for human meters and the meters and test strips are so much cheaper. We can help you with learning. Also, we all put our test results on a SpreadSsheet and if you look at everyone's signature under their cat's avatar you will see SS and if you click on it we can view each other's SS and help with dosing questions.

I just saw Squeakycats post above and she ask some good questions. At the vet, the kitties are so stressed out which can cause their BGs to be higher and then the vets recommend the dose on that inflated figure.

There is a lot to take it and learn and we all know how overwhelming it is but, we will help you every step of the way. The most important thing right now is to get a meter and test strips and learn to test Molly. Walmart has very affordable meters called Relion and there are different ones. I use the Prime because the strips are the cheapest at of all of them.

If you need help, just yell.

And I forgot to say Welcome!!
 
Last edited:
To answer questions:
* She is overweight for sure.

* Her only test done so far was at the vet and done prior to removing dry food.

* I have a meter kit - cousin gave me a onetouch ultra. I am comfortable doing this and the insulin.

* Been calling around trying to find a better deal in store today for the test strips. I need something before tomorrow so internet deals will have to be next.

* The suggested dosing I read on here was what prompted me to ask this question. 2 units seemed really high. when my cousin said the human Dr's start low and increase as needed especially during the first week I knew I should look this up before giving her the first dose.

* She's been nibbling, napping and talking to the wall as usual. =) Nothing out of the norm for the last 10+ years, No signs of illness or stress other than being overweight.

*I will go ahead and test her in a couple minutes. Was hoping to find a better deal than $40 for 25 test strips locally (Seattle) but this is more important right now. Will reply with results.



Hello Everyone!
New here with my 14 yr old cat, Molly, who was recently diagnosed.

I understand that no one here is a vet and every cat is different but I am curious if anyone knows if 2 units is not too high for 1st round of dosing? (considering the standard starting dose amount listed on here was 1 unit)

Molly's Stats:
*Weight - 5.27 kg
*Glucose - 406
*Feeding - She's a nibbler... almost never eats a large amount in one sitting. Even when she does it is never the full meal.

*Food
Current - Combo of canned and raw with a tiny amnt of her old dry as a treat while I'm transitioning her off of it. (she has maybe eaten 10-15 pieces in 1 day)

Past- was the same as above, she just ate less of the wet and more dry.

I have not rcvd the level of info and support I thought I would/should get from the vet and am very thankful I found this page.

Thank you for your time,
Abby
 
Oh, yeah, if the initial test was before you changed the food, I'd be scared to do 2 units without some more testing first! It's great that you are ready to go!
 
Welcome Abby and Molly

As mentioned above ReliOn has some of the cheapest strips for their meters compared to other meters and the strips they use, ReliOn is Walmart's brand of human meter, the Prime strips are about 20 dollars for 100 strips.
 
Thanks for the suggestions/info all. I feel ready to start her tomorrow and NOT.

I dont have my emergency kit yet so going shopping in a few, getting the spreadsheet started and printing emergency protocols when I get back.

The vet just called me back re: my concerns and said any reading over 159 would require a 2 unit dose which still really concerns me. I'm with you all on starting low, slow and consistent till we know for sure what her body really needs but the vet disagrees. I want to go to a different vet but I had signed up for a year long wellness plan contract prior to figuring out that I'm not happy with them so I feel stuck!

I think the best thing is not to take chances. I'm sure they will have something to say about my choice bit I'm not risking my cats life.
 
Am I right in remembering that people usually recommend the relion "Confirm" or "Micro" over the "Prime" because the first two require a smaller blood sample?
 
Thank you, I will look into the cost for a new kit, etc and include that in my errands today.



Welcome Abby and Molly

As mentioned above ReliOn has some of the cheapest strips for their meters compared to other meters and the strips they use, ReliOn is Walmart's brand of human meter, the Prime strips are about 20 dollars for 100 strips.
 
Not sure about sample size for prime but I read elsewhere that the "micro" was,a bit overkill for cat needs and the "confirm" was good. (both use .3ul)

Am I right in remembering that people usually recommend the relion "Confirm" or "Micro" over the "Prime" because the first two require a smaller blood sample?
 
Am I right in remembering that people usually recommend the relion "Confirm" or "Micro" over the "Prime" because the first two require a smaller blood sample?
I think that and smaller drop of blood to test is required by the Confirm and Micro and some peeps had issues with the Prime shutting off in the middle of the test. . I started off with the Micro and switched to the Prime because the strips are so much cheaper. I have not had any issues with the Prime meter at all.
 
Abby, you have really done your homework! :) And I am so glad that you will be testing her to keep her safe. There are some good video's in the stickies at the top of all the Insulin Support Groups. So glad you found us because this board knows so much more about Feline Diabetes than most vets as a lot of beans euthanize their animal with this DX and so sad because it's so treatable and a lot of cats go OTJ ( off the juice) once they get to a better low carb wet diet and some help from exogenous insulin.

Some of the information you will want to include in your signature is date of DX, age of Molly, any other health issues, meter you are using, food you are feeding, state or time zone you are in, and any other info you'd like us to know about you and Molly. Other pets in the house and their name. Favorite quote, all needs to fit on 3 lines.

Keep posting and keep asking questions as that is how we all learned. :cat:
 
Lily & I have used the Relion Prime meter from the start and have never had an issue. The blood drop required might be larger than the Confirm or Micro but it still isn't that large by any means. And you can buy 100 test strips at Walmart for under $18. :)
 
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