? 2/21 New member Priscilla! Lantus struggle, dosing advice needed

PriscillaGia

PriscillaGia

Member Since 2026
I posted my below welcome message that was already answered. I am now understanding I’ve been holding her doses too long. After an increase on her third day, she went hypo, but it is to be noted that whenever she has gone hypo historically she has never shown symptoms. Her numbers were just low. Moving forward I am looking for dosing advice and realize I should probably have been more aggressive and not hold them as long since I have time to do TR. I lowered her dose a drop because I started a new pen and I would like to go back to the dose she was at before the pen which is 0.75M. I’d like to know if this is a smart move or if I should move her back up to the dose that she was only on for three days and hit a low number on 2/16. I’m learning about what to do with low pre-shot numbers and I am realizing on that third day I should’ve handled it differently. Sorry for the rant just looking for any dosing advice from everybody here appreciate your time in advance!




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Hi all! I am so happy to be here! Priscilla my black beauty was diagnosed in November. She was on a kidney diet (very high carb, yikes!) that I think unmasked her latent diabetes. Since November I have switched her diet to zero carb homemade food with a completer, got a persistent UTI under control, and started her on Lantus...she is already back to her healthy weight!I am a member of a FB group that has been helpful but I am in need of more expertise. Early January is when things get interesting. The last piece of the puzzle was a dental, which she had never had. The week before Priscilla had the most beautiful numbers, what would be considered WELL regulated. Dental went GREAT, one extraction, nothing concerning, she healed beautifully, but since then I have absolutely struggled to get her back to the beautiful numbers she had and her thirst is increasing more and more and I am getting worried. ALSO her nadir changed almost overnight from +2 +3 +4 to +6 +7 +8. I reduced her dose on the dental day and have been creeping it up ever since. It seems she is requiring more insulin than before the dental. The dose that gave her great numbers seems to low. It's been 1 month and a half and all that has changed is I blend her food now. (I realized she preferred her food in a puree by accident, she started finishing her bowl rather than leaving a little behind, AI says this could be a reason for the nadir change and insulin sensitivity change). I also realized her insulin vial was 4 months old, so I started her on a fresh Lantus pen last night at a reduced dose. I would love LOVE LOVE the experts here to take a look at my SS, after this post I will work to convert them over to this forum's format so I apologize in advance. You will clearly see pre-dental vs post-dental. Are we on the right track? Are these changes normal post dental, later nadir, needing more insulin? Was it a good idea to reduce with the new pen vial? How many days should I hold this reduced dose before increasing? Am I doing anything wrong? I could go on but I will try to not to overwhelm with too many questions. Thank you in advance for taking the time and we are very happy to be here!
 

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Hello and welcome.

I think your spreadsheet is from an FB that took ours and modified it, causing some errors to appear on some platforms. If you can send a PM to @Marje and Gracie she can get you converted fairly quickly.

The thing with following TR, you have to always get a second test in the PM after the PMPS shot. It doesn't have to be mid cycle. If your before bed time is at least 2-3 hours after the PM shot, that's a good time to get the test. That will gives us a clue if she's diving low at night. This test is a requirement for Priscilla's safety. Many cats go lower at night and we change doses based on how low the dose takes the cat. If you cannot get those extra PM tests, SLGS would be a better dosing method for you. Some people can't due that, due to medical or lifestyle issues. We work around that and consider the cat's safety first.

Another thing for you to consider is that we change doses by 0.25 units at a time. I don't think your cat needs those fat and skinny doses as this point.

Here's that link to your first post on Health, for continuity: New member Priscilla here! Lantus struggle post dental
 
Wendy&Neko said:
Hello and welcome.

I think your spreadsheet is from an FB that took ours and modified it, causing some errors to appear on some platforms. If you can send a PM to @Marje and Gracie she can get you converted fairly quickly.

The thing with following TR, you have to always get a second test in the PM after the PMPS shot. It doesn't have to be mid cycle. If your before bed time is at least 2-3 hours after the PM shot, that's a good time to get the test. That will gives us a clue if she's diving low at night. This test is a requirement for Priscilla's safety. Many cats go lower at night and we change doses based on how low the dose takes the cat. If you cannot get those extra PM tests, SLGS would be a better dosing method for you. Some people can't due that, due to medical or lifestyle issues. We work around that and consider the cat's safety first.

Another thing for you to consider is that we change doses by 0.25 units at a time. I don't think your cat needs those fat and skinny doses as this point.

Here's that link to your first post on Health, for continuity: New member Priscilla here! Lantus struggle post dental
Click to expand...
Thank you so much for this info. Yes I noticed the spreadsheet looks very familiar. I will reach out to get it converted ASAP. I also edited mine a bit to suit my needs. The problem I am noticing is that Priscilla’s +2 and +3’s that I am able to get no problem almost always run high because she doesn’t dip into nadir till +6-+9. This is new for her (a month or so) so I am trying to adjust. Given her later nadir do you think SLGS is best? I am hoping to get her into remission but I am realizing I may have to let that dream go. Also is it safe to trial the TR method and if it becomes to much switch to SLGS or is that too risky to change methods? Thank you for your time! 🩵
 
Typical Lantus onset (when the insulin starts to take effect) is 2-3 hours after the shot, some, like my girl, a little bit later. I do see examples where Priscilla is going lower at +2 and those are the cycles where she is likely going to have an active cycle. Look to the PM cycle of Jan 10, a later test would have been good. A cycle with +2 or +3 higher than the preshot means a quiet cycle (likely a bounce).

Not sure I see a later nadir. I do see examples of cycles where she's resolving a bounce, and those once tend to have a later nadir.
 
Wendy&Neko said:
Typical Lantus onset (when the insulin starts to take effect) is 2-3 hours after the shot, some, like my girl, a little bit later. I do see examples where Priscilla is going lower at +2 and those are the cycles where she is likely going to have an active cycle. Look to the PM cycle of Jan 10, a later test would have been good. A cycle with +2 or +3 higher than the preshot means a quiet cycle (likely a bounce).

Not sure I see a later nadir. I do see examples of cycles where she's resolving a bounce, and those once tend to have a later nadir.
Click to expand...
I see. Ok, I will start diligently taking +2 and +3s, especially in the PM. I managed to transfer my data as well to a compatible sheet for the forum! Given the data I have collected so far how long would you recommend holding the 0.75F dose? I would lower her to an even 0.75 but since she is already on this dose I figure it is best to hold it here. For TR I believe she would warrant an increase based on previous data but I am terrified to move her up to 1u since 0.75F gave her a very low number on 2/16. For SLGS, does she seem to be in a good range to hold and assess after holding?
 
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