When to lower Lantus insulin

[Gemofnj]

Hello!

my kitty is on 4.5 units of Lantus insulin two times a day. We recently switched to fancy feast classic liver and chicken cat food on October 29.

his numbers are coming down quite steadily, and I was concerned about when I should reduce the insulin dose, or how to tell when to lower the insulin dose

any information or help would be greatly appreciated. I do not want to have a hypo event. Thank you so much.

PS. His numbers have dropped from high 400’s a for months, and now we had a low 252 this morning. I’m thrilled.

 

[Ale & Bobo & Minnie (GA)]

Are you home testing? We follow 2 dosing methods for Lantus here and you’d follow their guidelines for adjusting or decreasing the dose. We really can’t give you dosing advice if we don’t see some testing data.

Here is a helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help.

 

[Gemofnj]

Are you home testing? We follow 2 dosing methods for Lantus here and you’d follow their guidelines for adjusting or decreasing the dose. We really can’t give you dosing advice if we don’t see some testing data.

Here is a helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help.

Are you home testing? We follow 2 dosing methods for Lantus here and you’d follow their guidelines for adjusting or decreasing the dose. We really can’t give you dosing advice if we don’t see some testing data.

Here is a helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help.

Are you home testing? We follow 2 dosing methods for Lantus here and you’d follow their guidelines for adjusting or decreasing the dose. We really can’t give you dosing advice if we don’t see some testing data.

Here is a helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help.

yes, I have been doing extensive testing since day one. I belong to the Feline Diabetes FB support group, I have a chart link if you want to see it.
https://docs.google.com/spreadsheets/d/1FEwFZGk952pj_B32qKIEsKZKvQ4QysC9yoCmETKKrl0/edit

 

[Ale & Bobo & Minnie (GA)]

That’s great, good for you, and I’m happy to hear you’re getting lower preshot numbers!

We do the dose adjustments by the nadir, which is the lowest the dose takes your cat in a 12-hour cycle, not the preshots. Preshots are important to gauge if it’s safe to shoot, but we also recommend you try to get 2 more additional tests to catch the nadir. Usually with Lantus, that’s around +5,+6. We also suggest a +2 in the evenings so you can tell where his bg is headed for the night.

It looks like the dose you’re on now may be working let me take a look.

in the meantime, if you haven’t already, go to the Lantus forum and I recommend you read all the yellow sticky notes, especially the one on dosing and decide which method you want to follow. If you’re not feeding any dry food, you can go with either. TR requires more testing but had a higher chance of remission and many of us have actually gotten our cats into remission with it.

do you have a hypo kit?

 

[Ale & Bobo & Minnie (GA)]

Also, we do dose adjustments by 1/4 unit and it looks like you’ve increased by full and 1/2 units. Were you following a method or just going by the numbers? I see you stayed too long on a dose at times and not long enough other times. Are you willing to work with one of our dosing methods?

you’re testing a lot which is great so you could follow TR if you wanted

 

[Gemofnj]

Also, we do dose adjustments by 1/4 unit and it looks like you’ve increased by full and 1/2 units. Were you following a method or just going by the numbers? I see you stayed too long on a dose at times and not long enough other times. Are you willing to work with one of our dosing methods?

you’re testing a lot which is great so you could follow TR if you wanted

I always test preshot and at least mid cycle or more so I’m basically testing 426 times a day at random intervals. Plenty of testing !

I followed my vet, an internal medicine doctor for the dosages on Oscar, however, this last time she wanted me to go to five units, and I said no 4.5.
I have calipers, but I haven’t learned how to do that yet.
I will check out the Lantus forum. I am happy to take your advice for the dosing. At one point I did reduce his dose by half, and it was recommended by the feline, diabetes, Facebook group, and it made him even sicker and it backfired. He definitely needed an increase, not a decrease at that time. So I’m a little nervous.

currently, his numbers are steadily dropping, which is amazing. And I hope it continues. My main concern is a pancreatitis flare and he has a stomach motility issue. So far fancy feast is OK and his numbers are going down by quite a bit.

would he need to stay in a particular range consistently, I am concerned he will pop out into the 100s or lower one day without warning. Yes, I have hypo kit together.

 

[Diane Tyler's Mom GA]

Welcome Lisa and Oskar , saw your name on your SS
You couldn't have found a better group to join, we have a lot of experienced members here, who gave me their advice and I took it and now Tyler has been in remission since 1-24-21

Like Ale had asked can you fill out your signature please ,that's the first thing our members will look at. I see you have in your SS in yellow please add that also in your signature
The signature is at the end of everyone's post in gray ,information about our cats

• Add info we need to help you:
  • Caregiver & kitty's name
  • DX: Date
  • Name of Insulin (do not include dose or frequency)
  • Name of your meter
  • Diet: "LC wet" or "dry food" or "combo"
  • Dosing: TR or SLGS or Custom (if applicable)
  • DKA or other recent health issue (if applicable)
  • Acro, IAA, or Cushings (if applicable)
  • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
  • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.

Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.

Also almost all of us use human meters that's what our numbers are based on


You can read all about Lantus here
https://felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/

Do you have the U-100 syringes with the half unit markings?

 

[Ale & Bobo & Minnie (GA)]

I always test preshot and at least mid cycle or more so I’m basically testing 426 times a day at random intervals. Plenty of testing !

I followed my vet, an internal medicine doctor for the dosages on Oscar, however, this last time she wanted me to go to five units, and I said no 4.5.
I have calipers, but I haven’t learned how to do that yet.
I will check out the Lantus forum. I am happy to take your advice for the dosing. At one point I did reduce his dose by half, and it was recommended by the feline, diabetes, Facebook group, and it made him even sicker and it backfired. He definitely needed an increase, not a decrease at that time. So I’m a little nervous.

currently, his numbers are steadily dropping, which is amazing. And I hope it continues. My main concern is a pancreatitis flare and he has a stomach motility issue. So far fancy feast is OK and his numbers are going down by quite a bit.

would he need to stay in a particular range consistently, I am concerned he will pop out into the 100s or lower one day without warning. Yes, I have hypo kit together.

You don’t need calipers. I mean they’re great but most of us use 1/2 units marked syringes. Do you have them? Vets always want to up by full units or more but we find that you risk speeding right through the ideal dose. The goal is for them to be in the normal range for as long as possible which is 70-120, but regulated cats can still get up to the 200’s. The decrease number depends on the method you pick. With TR, you only decrease when they go under 50 and with SLGS under 90. I think you could do TR if you’re not feeding any dry food.

 

[Sienne and Gabby (GA)]

Welcome to the "mother ship." If you're a member of the FB group from FDMB, I suspect you will get more tailored guidance here. We actually insist on looking at your spreadsheet. Personally, I won't provide any input on dose without looking at a cat's spreadsheet and we ask that you link the sheet to your signature. The information on how to do so is in the helping us to help you post that Ale also linked.

We take a different approach to dosing than your vet. No offense to your vet, but this board has 25+ years of experience with feline diabetes. I'd encourage you to read over the dosing methods sticky note on the Lantus board.

Please let us know how we can help!!