Hard time regulating my cat after a week of Lantus.

[Leonidas]

Hello all.

I am hoping for some guidance after about 8 days of Lantus shots. His Pre-shot numbers are getting much lower and I want to make sure what I am doing with his dosing (or not shooting) is okay, or correct my behavior before I do any harm.


General Info:
- Diagnosed 4-15-2021, started Lantus 4-19-2021.
- Food: transitioned from Purina Indoor Advantage (dry) to Blue Wilderness Wet Can food

• Protein 28%
• Fat 69%
• Carb 3%

- Getting Lantus Insulin 2x a day around 5:30AM/PM.


Dosage and Pre-Shot Numbers:
Day 1: After the first 2 shots (1.5u), due to a curve that worried me (4-20), I called my vet and they advised I reduced the dosage by 0.5u which I did.

Day 2-5: Leonidas received 1u per shot. Pre-shot numbers in the low 300’s with Nadir’s in the mid 100’s.

Day 6-7: we dropped his dosage again by 0.5u, pre-shot numbers in the mid 200’s

Day 7: PMPS was 130.

• This was too low for me to feel comfortable giving him insulin. I looked around the site and it seemed okay that I skipped a shot if I wasn’t sure?

The last 2 days with Pre-Shot numbers in the low 200’s I reduced his dosage to about 0.4u.

Today PMPS number was 173. Just to be sure I tested twice. So I opted to not give him a shot again.

My Concern:
I feel like I shouldn’t be skipping shots like this, or maybe reducing his dosage at all? I am no longer able to test him mid-day due to being at work, but can still test him during the mid-shot time at night.

If someone can give me guidance or opinions on how I should proceed, that would be fantastic.

Thank you.

 

[Chris & China (GA)]

OK...the first thing to try to remember is that Lantus dosing is based on how LOW it takes him, not the Pre-shot. The Pre-shot only tells us if it's safe to give insulin at all.

At first, if you get a PS that's under 150, you should stall, don't feed and test again in 20-30 minutes to see if the number goes up without the influence of food. Use that time to post here too with a good subject line like "STALLING! NEED HELP!"....once you have somebody to help you, you can go back and edit your subject line again.

We have a tradition here. If somebody encourages you to shoot a lower PS than you're used to, they also agree to stay online to watch for updates, even if it means staying up most of the night with you. We won't tell you to shoot and then disappear!

Lantus works best at lower numbers. I know it seems like if (for example) 1 unit dropped him from 400 to 200, if you shoot that 1U at 200 he'd drop to zero but it doesn't work like that! With Lantus, you learn to "shoot low to stay low". After I had enough data and experience, I'd shoot China if she was above 50 (but we did Tight Regulation) but even on SLGS, you work your way to where you'll shoot anything over 90.

Here's some good information on "Can I do TR with a full time job"?....even if you're not doing TR, there are some good ideas there!

If you can't get mid-cycles on the AM cycle due to work, then yes, it's good to get a couple tests on the PM cycle and then do a curve on days you have off.

How are you measuring .4? Most of us have enough trouble with .5 and .25 to be trying to get in between.

If this were my cat, I'd probably go back to .5 and hold that dose unless he earns a reduction by dropping below 90. Lantus craves consistency so every time you change the dose, the depot has to adjust too before you see what that dose is actually going to do for him.

 

[Leonidas]

Thank you for your reply.

How are you measuring .4? Most of us have enough trouble with .5 and .25 to be trying to get in between.

Estimation i guess. But yeah its hard to be real accurate but it was a hair under the .5 mark, but not quite at the half level.

If this were my cat, I'd probably go back to .5 and hold that dose unless he earns a reduction by dropping below 90. Lantus craves consistency so every time you change the dose, the depot has to adjust too before you see what that does is actually going to do for him.

That makes sense, thank you. I just got concerned when I read the "Dont shoot under 200" things. Thank you for putting my mind at ease, i will give him .5 and see how he does.

Thanks!

 

[Wendy&Neko]

The "don't shoot under 200" is for people who are new and don't have much data. With time, experience and data, that number can be lowered. I think you could still consider yourself to be new, so it was fine to skip tonight. Good to see you got a later test to see what happened.