Lantus dosage - Need help

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catman13

catman13

Member Since 2018
Hi,

I have a diabetic cat about 6 year old that weighs 9-10lbs.
She was on Novolin N, 2.5u twice a day and wasn’t doing that great, BG between 350-550.

2 days ago we switched to Lantus and started at 1u twice a day. Seems that she’s hanging around 360-430 BG, better than before but not quite down to where she should be.
I’m aware that Lantus is a long term insulin and may take some time to take effect. She’s only had 4 shots of 1u each in the past 48h.

Question: is it too soon to increase the Lantus dosage? Should I wait few more days to see if she drops further or is it better to go to 1.5u twice a day for now and keep monitoring?
 
Hello and welcome here. Any chance you could put together a spreadsheet showing the doses and your test values? The instructions are in the New to the Group Sticky Note. Without that data, it's very hard for us to make suggestions on dose.

We hold the initial dose 5-7 days to build the depot, so I wouldn't increase yet anyway. And we typically make chang s by 0.25 units at a a time,
 
Thank you for the quick reply. I’m using my phone so it’s a little harder to access the spreadsheet. The following are my measurements:
6/27 at 8pm: 410 (1u given at that time)
6/27 at 11pm: 427
6/28 at 8am: 433 (1u given at that time)
6/28 at 11am: 363
6/28 at 3:30pm: 439
6/28 at 10:45pm: 384 (1u given at 8pm)
6/29 at 10:45am: 403 (1u given at 8am)
 
Typically when we switch from one insulin to the other, we take the dose of the previous insulinninto consideration. So, given what the spreadsheet says, might have started closer to the Novolin dose. I would still hold the dose at this point. Any chance of getting access to a computer to create a spreadsheet? If not, there may be someone here who can set it up for you so all the ounhave to do is Google Sheets to modify it,
 
I'm with Wendy -- it's too soon to change the dose.

Also, what are you feeding your cat? The amount of carbohydrates in what the food your providing influences the numbers you're seeing.
 
Wendy and Sienne thanks for the advice.
I can do the spreadsheet when I have access to my computer.

As far as food, right now I’m giving her pro plan wet food with dry carb % between 2% - %8 ..
But I have the hills W/D dry food which was prescribed for my other cat, that one has 47% carbs and she nibbles on it at times during the day.
I ordered a bag of nature valleys instinct dry food, which has 22% carbs and high in protein. Hoping that one will be better than the W/D.
 
Yuck on the dry food carbs! :eek: If it was prescribed for your other kitty for weight management, you'll find switching to all wet will help the weight too.
 
It was prescribed for high fiber because of anal glands issues.
But honestly no difference was noticed and he’s been on it for 5 months .. so going to switch it to nature valleys instinct since carbs are a lot less on that one.

Will let you kno how Lilly does on BC in 2-3 days
 
Hi and welcome! We're glad you found us.

As Sienne and Wendy have mentioned, it's best to feed a diabetic cat a low carb food, and almost all dry foods are way too high in carbs. It's recommended to stick to something that's below 10% carbs. If you take a look at Dr. Lisa's food list, you can see which foods are best. Dr. Lisa makes some excellent points on why dry food is bad for all cats. Check out her full site at catinfo.org.

We have people here that update their spreadsheets from their phones, so once you can get to a pc and set it up, you should be good to go. Ask if you need help. We have some people here that are very good with it.

When you have a chance, please check out this post: http://www.felinediabetes.com/FDMB/threads/updated-tips-for-new-members.173572/ It's kind of an FAQ for new members. Ask lots of questions. We love to help!
 
Hi all,

I just got the Nova max ketone test kit and I tested Lilly 2 days. First reading is 0.9 and second reading was 1.6. Normal level usually is less than 0.6 while moderate is 0.6-1.5 .. 1.6-3.0 is considered and high. And above 3.0 is really high. Do these levels still apply for cats?

She’s not showing any signs of DKA. She’s active and eats and drinks normal.

I’m starting to think it’s because her BG has been lingering between 375-410 lately ..

It’s been a week since we started Lantus, I called he vet 2 days ago and we increased her dose to 1.5u twice a day. She’s been on the new dose for 48h now and still no decrease in Blood glucose levels.

Could it be that she’s building tolerance against the insulin? Should I try increasing to 2u twice per day? I’m really not liking that her BG is constantly at a very high level.

Any help would be appreciated, I’m getting worried with this ketone issue.
 
Hi - Hope you have been able to get a spreadsheet going. If not, please let us know what help you need or share the link. Experts will need to review your spreadsheet to offer comments on dose. My first thought is 48 hours is too soon to make an increase.

Meanwhile, I wanted to share an important link regarding ketones. Please make sure you have this info handy. From a recent post, I copied this information for you: The latest published research/studies in cats indicate ketones will begin to show up at readings of 2.4 and 2.55 on a blood ketone meter

Ketones will show up in blood before the urine.

Given it is a Holiday, traffic on the board today may be light - just wanted to get you started with some background reading and prep for those who can give dose advice.
 
Hi Carol,

Thanks a lot for the help this link was very helpful.
If you could share a link for the spreadsheet that Would be helpful too.

Just to make sure I got this correctly, what you copied about ketones means that the 1.6 reading doesn’t indicate any presence of ketones. Am I interpreting this correctly?

Thanks again for your help
 
This link for spreadsheet instructions comes from the "New to the Group" sticky note (at the top of the forum). You will want to read that when you have a chance.

I'm not an expert in ketones, so I don't want to say you shouldn't worry about 1.6 - it is my understanding this number is still very low but should be watched over time to make sure it doesn't increase. Does she have a history of DKA? I'm going to ask others with more experience with ketones to please comment especially since you have seen an increase over 2 days from .9 to 1.6. @Bobbie And Bubba , @Sienne and Gabby (GA) can you please comment on blood ketone meter readings for a new user with BG uncontrolled (375 - 410)?
 
Hey there. Yes, that 1.6 is still no ketones. When using a human blood ketone meter on a cat, the number that ketones are present starts at 2.4.

I'm on my phone so I can't copy the link about ketones but I will.

Just some housekeeping , could you start a new thread each day with the date? That helps us to help you better.
 
Here is the links about ketones in cats using a human meter.

The latest published research/studies in cats indicate ketones will begin to show up at readings of 2.4 and 2.55 on a blood ketone meter:Measurement of ketones - Weingart_J VET Diagn Invest-2012(1).

Measuring ketones - JSAP_Zeugswetter - 2012.pdf

Here is the link for setting up a Spread Sheet. If you have any trouble just yell and someone can help you . It is a great tool and it will help you to see patterns and trends and it helps us to help you. It's hard to determine dosing by a written tally of numbers. Then set up a signature like we all have and attach it to the signature. Tell us about your kitty, date diagnosed, insulin you are using, food you are feeding, any medical issue, kittie's date of birth and where you are geographically so we know your time zone.

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
 
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Bobbie, thanks for the advise. And will do regarding the threads. I’m sorry I’m still trying to get the hang of this.

I tested Lilly’s Ketones again this morning and it’s down to 1.1. However she’s had diarrhea since last night and vomited this morning (fluidy)

Her BG still at 400+. I’m going to try to get the spreadsheet filled out ASAP. I can start a new thread with the spreadsheet.

Thanks for all your help.
 
catman13 said:
Bobbie, thanks for the advise. And will do regarding the threads. I’m sorry I’m still trying to get the hang of this.

I tested Lilly’s Ketones again this morning and it’s down to 1.1. However she’s had diarrhea since last night and vomited this morning (fluidy)

Her BG still at 400+. I’m going to try to get the spreadsheet filled out ASAP. I can start a new thread with the spreadsheet.

Thanks for all your help.
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How is she eating? Has she had a history of pancreatitis? A probiotic, Florastor, you can get from CVS works wonder for diarrhea. 1/2 a capsule in there food twice a day. Continue until the diarrhea stops and then go to a maintenance dose of 1/4 capsule twice a day for 3 days.

A tsp of pumpkin in her food twice a day helps also with diarrhea. Pure pumpkin not the pie filling pumpkin as that has sugar.

Since she has diarrhea, add some water to her food to help out with not getting ketones as she is losing water with the diarrhea and water helps to flush ketones.
 
She drinks a lot of water. She’s been eating good. (Mainly low carb wet food and she nibbles on dry food with 22% carbs and high protein, which is better than most dry foods as far as carbs)
 
catman13 said:
She drinks a lot of water. She’s been eating good. (Mainly low carb wet food and she nibbles on dry food with 22% carbs and high protein, which is better than most dry foods as far as carbs)
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I would ditch that dry if you can. 22 % carbs is really high. We want to see our diabetic kitties under 10% carbs otherwise it will be very hard for you to get her into better numbers. Glad she drinks a lot of water.
 
Problem is I have 4 cats and the one only eats dry food.
So I tried to go with one that has the lowest carbs I can find.
 
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