3/10 Lantus Input

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KatieDarling622

Member Since 2019
Looking for some input/knowledge about the dosing that I'm currently giving my cat.

Background - Tux is a 9 year old male, almost 10, who was diagnosed this past August. Started on NPH and was up to 5U twice daily before swapping to Lantus in February. Started on 1U daily, and currently up to 1.75U. I don't have a good spreadsheet of his readings from when he was on NPH, but he was regularly between 300-550 pre-shot and never went below +/- 250.

As for diet, I free feed Dr. Elseys Clean Protein Chicken as I have two other cats (one hates wet food). Aside from that, any wet food that's under 5% carbs I give Tux. Usually we feed around 6/6:30AM, 11AM, 3PM, 6PM and maybe 9PM - splitting 4 small cans over the course of a day for him.

Since starting on Lantus, his pre-shot numbers have dropped to 300-350 or lower which I'm happy with! I'm not able to get a lot of data during the day unfortunately as I work so much.

Really just looking for opinions on his numbers so far. My vet has been great, but she doesn't have a lot of diabetic cats coming through her practice (:

https://docs.google.com/spreadsheets/d/1Qjl5l1mUN9Yt5uIA4_Pwe13Ebn948aca0WP6BYoruYM/edit?usp=sharing
 
All the insulin dosing protocols I'm aware of, for any insulin, not just Lantus, need mid-cycle tests in order to adjust the insulin dose.
You need to know "how low he goes" aka the nadir, on a particular dose of insulin.
What did your vet base the insulin adjustments on? What data?

The only thing the pre-shot numbers tell you, is that the BG levels are high enough to give the insulin dose in the first place.

Thanks for including the feeding times. but we live everywhere in the world and saying 6 am your time may be 1 am in Australia the next day, or 11 am in the UK. Also, giving the feeding times in clock time does not help to put the feedings into context with when the insulin shot is given.

If you could restate those feeding times in + hours, with notes if that is the AMPS or PMPS cycle, just like you would do with the BG tests, that would be more helpful.

Would you do that please?
 
I'm assuming she's basing the adjustments off of his pre-shot numbers. Getting mid-cycle numbers has proven difficult with my work schedule, but I get what I can. My mom feeds him but with her medical condition she cannot give him a shot or check his BG. I plan to do another curve this weekend since I have a day off.

Feeding schedule is as such (we're in the US-Florida)

6AM AMPS - Feeding: 3/4 Can Fancy Feast Pate
6:30AM - 1.75U lantus
+3 - 3/4 can FF
+6 - 3/4 can FF
+9 - 3/4 can FF
6PM PMPS - Feeding: 3/4 can FF
6:30PM - 1.75U lantus
+3 - 3/4 can FF
(Overnight - free feed Dr. Elseys)
 
Is that the Dr. Elsey's wet or dry you are feeding overnight? Notes in the Remarks column and in your signature would be useful.

Feeding after the middle of the insulin dosing cycle, when basically the insulin is "used up", can keep the BG numbers higher in the last part of the 12 hour cycle.

Without some mid-cycle test data, there isn't enough information on the SS to know if this dose is a good one or not. We have no idea how low the dose is dropping your cat. There isn't enough information there to base a recommendation on.
KatieDarling622 said:
I'm not able to get a lot of data during the day unfortunately as I work so much.
Click to expand...
Understood. Curve on the weekend could be good information.

But you might consider getting some regular daily tests after that PMPS test. For instance, you can get a +2 test every PM cycle. And then another test before you go to bed.
 
I would try and get some testing done in the PM cycles and at weekends if you work during the day. The pm cycle is just as important as the am cycle.
Try and always get a before bed test in every night. If the before bed test is lower than the Preshot number, then that is telling you that it will probably be an active cycle so you may want to set the alarm and get up later to check that the BG level has not dropped too low.
Finding the lowest BG in the cycle (nadir) is important as Lantus is dosed on the lowest point, not the Preshot.
It is very possible for a cat to have a Preshot at say 400 or 350, drop to 50 or lower during the cycle and then bounce back up to 400 at the next Preshot. If you are not testing you will have no idea this is happening. If you increased the dose with this scenario you would be risking a hypo.

Its great you are home testing!
 
If you can grab a +3 at night and get tests in mid cycle on days you aren’t working it will help figure out what’s going on with the nadir.
 
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