? I need Help with insulin (Lantus) for my kitten Luna!!!!!!

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Tatiwen

Tatiwen

Member Since 2020
Hello Community,

Yesterday I did a post sharing about what I have to deal the 2 weeks since my kitten Luna was diagnosed with diabetes.

The thing is she had a follow up visit with the vet to review the BG curve I did on Sunday. I spent 1hour talking with the vet about all the research I have done about Feline Diabetes and seems as he was surprised about each topic I have mentioned.

- When I asked him about Methyl Cobalamin, he does not have a clue about what I was talking about and how this could help the Neuropathy Luna is having. He only told me that if I want he can give her a shoot with the regular B-12. :S

- The second was the food, I told him I switch Luna to wet food and also trying raw food. Again he didn't know how the dry food can affect the diabetic cat ( all cats indeed) due to the high percentage of carbs. He says it is my decision but he reinforces the importance to continue feeding her with the glucose support because of the fiber the product has and bla, bla, bla..... He also highlighted the danger of giving contaminated raw food and the bacteria it could have.

-Finally, after he reviewed the number of the BG curve and BG of the other days, he said Luna is doing very well and asked me to continue with the same dose 0.76U and he argues that one shoot a day is enough. Also asked me to stop testing her to give her a break of all the punctures on her ears and that I treat her only base on the clinical behavior, something like if I see her lethargic or with convulsion then take actions. I told him I will not give her a shoot without knowing what is her BG because I'm not willing to cause her hypoglycemia.

To be honest I was not happy with all this as he demonstrated not knowledge at all. No even after I share all info I have found here in FDMS.

To not make this post longer, what I want to ask is your advice about the Lantus insulin.
Should I start giving here 2 shoots per day, if so what should it be the recommended dose? You can see how she behaves with only one shoot per day in her spreadsheet under my signature.

What is the range of BG pre shoot that should stop me to give her the shoot? As an example this morning she was 181, I was reluctant to give her the shoot, but I finally did it. The good thing ( I think) is 5 hours later she was 149.

Thanks in advance,

Tati and Luna

 
It depends on the protocol you’re using for dosage which is missing from your ss but for SLGS it’s this:

http://www.felinediabetes.com/FDMB/...-low-go-slow-slgs-tight-regulation-tr.210110/

Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?
A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines.
  • Below 150 mg/dl (8.3 mmol/L), don't give insulin.
  • Between 150 and 200 (8.3-11.1 mmol/L), you have three options:
    • a.) give nothing
    • b.) give a token dose (10-25% of the usual dose)
    • c.) feed as usual, test in a couple of hours, and make a decision based on that value
  • Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.
  • In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine.
  • Above the normal pre-shot value, give the usual dose, but if the pre-shot value is consistently elevated, it's a good idea to schedule a full glucose curve to see whether a change in dose or insulin is appropriate. In most cases, the target "peak" value should not be below 100 mg/dl (5.6 mmol/L), and for some cats it might be higher.
Keep in mind these are general guidelines, and they should be personalized to your own cat's response to insulin. If your experience is that your cat does not became hypoglycemic with a dose which is close to her usual, then personal experience should be your guide.
 
Yes, definitely two shots a day, 12 hours apart.

Looking at the data you already have, I think I might be inclined to try a slightly lower dose when you go 2x/day, perhaps 0.5U. That's lower than our usual starting doses, but if it ends up being too low, you can always go back up.

My reasoning: 0.75U once a day is doing a good job of bringing Luna down from yellow numbers into blue and even (several times) green numbers. That looks like the right dose for her! However, you also have to consider the action of the lantus "depot"-- a little bit of each shot "saved for later". Right now, since you aren't giving the PM shot, "later" is those 12 hours of the night. There might be a little carryover into the next morning, but not as much as there would be if you were shooting 0.75U both morning and night. I worry that, after the first few shots building up the depot, you might find yourself giving too much insulin.

So, how about 0.5U twice a day?
 
Nan & Amber (GA) said:
Yes, definitely two shots a day, 12 hours apart.

Looking at the data you already have, I think I might be inclined to try a slightly lower dose when you go 2x/day, perhaps 0.5U. That's lower than our usual starting doses, but if it ends up being too low, you can always go back up.

My reasoning: 0.75U once a day is doing a good job of bringing Luna down from yellow numbers into blue and even (several times) green numbers. That looks like the right dose for her! However, you also have to consider the action of the lantus "depot"-- a little bit of each shot "saved for later". Right now, since you aren't giving the PM shot, "later" is those 12 hours of the night. There might be a little carryover into the next morning, but not as much as there would be if you were shooting 0.75U both morning and night. I worry that, after the first few shots building up the depot, you might find yourself giving too much insulin.

So, how about 0.5U twice a day?
Click to expand...

I will start tomorrow at let you guys know how it goes!!
 
I would make a very strong recommendation that you get at least one test during the PM cycle. Lantus dosing is based on how low (i.e., the nadir) a dose brings your kitty. Some other types of insulin take the pre-shot number more into account. So, if you aren't getting a test during the PM cycle, you end up missing half of your data. You also don't know if Luna is in safe numbers overnight -- especially since some cats experience lower numbers at night. We encourage getting a "before bed" test every night.

Just as an example, your PMPS was 198 on 7/1. Your AMPS the next day was 139. Since the pre-shot numbers are usually higher than your mid-cycle numbers, it leaves me wondering how low Luna dropped during the PM cycle.

Also, you may want to consider posting on the Lantus board. There is a wealth of information in the sticky notes at the top of the board and the members on the board all use Lantus or Levemir.
 
Sienne and Gabby (GA) said:
I would make a very strong recommendation that you get at least one test during the PM cycle. Lantus dosing is based on how low (i.e., the nadir) a dose brings your kitty. Some other types of insulin take the pre-shot number more into account. So, if you aren't getting a test during the PM cycle, you end up missing half of your data. You also don't know if Luna is in safe numbers overnight -- especially since some cats experience lower numbers at night. We encourage getting a "before bed" test every night.

Just as an example, your PMPS was 198 on 7/1. Your AMPS the next day was 139. Since the pre-shot numbers are usually higher than your mid-cycle numbers, it leaves me wondering how low Luna dropped during the PM cycle.

Also, you may want to consider posting on the Lantus board. There is a wealth of information in the sticky notes at the top of the board and the members on the board all use Lantus or Levemir.
Click to expand...

Hi Sienne, Yesterday I posted on the Lantus board due to the low value she had on her AMPS test. I will start taking a measure of her BG during the PM cycle. Do you think testing her on +9 after her PM shot it ok or it would be better on +2. The issue is I'm giving her PM shot at 7 pm and I go to bed at 8:30 pm because I wake up at 4:30 am to feed the cats and then go to the gym.? Or I should wake up at midnight to measure her BG?

Luna is getting so stressful any time I need to poke her ear that I was hoping that testing her only before her shots will be enough but I will do what it is better for her. Thanks in advance....
 
What time is your AM shot? I'm assuming it's at 7:00 if that's when you shoot in the PM.

What I did with Gabby was to shift my shot time to 5:00. I wasn't an AM workout person and Gabby had an early nadir so shooting at 5 AM allowed me to get a couple of tests in before I left for work and I could be home a few minutes after 5 PM. That way, I could also get the PM tests. This is my round about way of asking whether you could shift your shot time earlier so you didn't have to be up too late to get some PM tests.
 
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