Hi. New member here 12/20/25. Questions about Lantus and dosing

Hi. As the subject states. I’m new here so not sure how any of this works.
There’s lots of info to share about my kitty so not sure where to start. Please direct me and I will provide all the info. I need help with Lantus and how I’m dosing. Currently we are on 0.75 units the last few days, most times it works fine. This morning didn’t work at all. Last night didn’t work either , but that reason I know why.
I do have some more questions. But again, there’s quite a bit of info to provide.

All the Lantus info is here: Lantus / Levemir / Biosimilars

But stay here on Health for now since you're a newbie Can you give us more information about your cat? How was the diagnosis made and when? Symptoms? Any ketones? Are you testing blood glucose levels at home or not? What are you feeding your cat? What dose of Lantus did your cat start at and how long was he on that dose?

Hi. Thanks . I actually just read about all the threads on Lantus before I joined . Full disclosure.. before I get into all the info. I’ve been a vet tech for abt 17yrs. I currently work in a 24hr ER hospital where I have IM drs I work with. They are only half helpful , which is why I’m here. It’s been abt 12 yrs since I’ve dealt with anything diabetic (and it’s never been my strong suit) I have since been a surgery tech and now I’m a radiation oncology tech that does anesthesia and delivers radiation. I have some knowledge but not much about insulins.

Lily has been diagnosed with steroid induced diabetes on 9/18/25. She gets her steroid EOD And her diabetes is quite mild.
She was started on 0.5u Lantus once a day. After a few days , 1 u once a day.. damn near made her hypo by morning so went to 0.5u BID. She eventually stopped needing insulin in the morning so we went back to SID. Which worked for her. Had some more hypo events went shooting under 300. So the plan was 0.25units <300 and 0.5 >300. I know that none of this is how Lantus works but this is what me and my IM VET worked out. She was extremely sensitive to insulin. Not only that, but her BG was actually dropping after she ate, not going up so she was making some of her own insulin.

FAst forward to couple weeks ago , she stopped responding to insulin. I suspected pancreatitis. I was right , I caught it quick and have been managing at home. She lost whatever insulin she was making and became more insulin dependent. Her insulin got bumped to 1 unit BID by a different IM VET bc her vet was out for a bit . I Feel like , even with pancreatitis , 1 unit is a lot for her and it terrifies me , especially since she’s doing better.
I bumped her down to 0.75units BID. most times it works, sometimes it doesn’t. Last night didn’t work bc it was steroid night. This morning didn’t work and not sure why. But it has been working just fine for her
With her steroid nights , I feel like she could benefit from 1 unit. I spoke with our medical director, who is also an IM vet. And he said it was fine to give her 1 unit on her steroid nights and 0.75 other times.
Can this work? I know this is not how it typically works but I don’t know what else to do otherwise she’s high all night on steroid nights. Not sure why her insulin didn’t even work this AM
I HAve a FSL 3+ on her to watch trends and I check her AM/PMPS with an AlphaTrak
IM SORRY, this is ALOT OF INFO

Not sure if you’d be able to see this. But Dec 4 is when she was at work with me and got diagnosed with pancreatitis. AM/PMPS are AlphaTrak numbers , numbers with * are also AT, rest of post shot numbers are FSL

Any chance you could link the spreadsheet document in your signature? More information here: New? How You Can Help Us Help You!

With the dosing methods we use here, and since Lily is eating high carb dry food, you would stay with this dose for 7 days before deciding if the dose needs to be change.

I’m a little worried about waiting 7 days if her numbers are going to stay high. Before she got diagnosed with pancreatitis , on the dose she was on .. it took only a few days for her to start showing symptoms to the point where I had to start checking her ketones everyday until I had my appointment. Her steroid nights spike her a lot more than her food does.

Has Lily shown ketones in the past? If so, that's important to add to the signature.

Lily hasn't been staying high all the time. I think she got down to 114 a few days ago? Sorry, finding that copy of the spreadsheet hard to read. I suspect Lily will not stay high on this dose, but rather is doing something we call bouncing.

Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

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You want to try to avoid increasing when she is clearing the bounce. Meaning, time for patience.

She has not had a drop in blood sugar in over 24hours. Isn’t a bounce something that happens right away ? A few days ago. She got as low as 90 in her FSL after the 114. But never had a bounce from that

Or can a bounce happen either right away or over time?

The most she’s had with ketones is 2 on a meter with blood. Usually it reads low. She didn’t have any when she got diagnosed.
I will link her spreadsheet tomorrow.

Most cats will bounce shortly after a large drop or lower number than they are used to. But a few cats, like mine, will sometimes delay the start of a bounce. Bouncing doesn't mean solid high numbers, there can be some wobbling around in numbers.

It's good to show the lowest numbers on the spreadsheet, as we like to know how low the dose can take the cat. With dry food in the picture, you don't want them going any lower than 90 on a dose. You did say that was with the Libre. Have you done side by side comparisons between the Libre and the AT? Often the Libre reads lower in numbers under 100.

DBSG & Lily said:

Or can a bounce happen either right away or over time?

The most she’s had with ketones is 2 on a meter with blood. Usually it reads low. She didn’t have any when she got diagnosed.
I will link her spreadsheet tomorrow.

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I just wanted to remind of one of the mottos since here. Every Cat Is Different. Bounces can act and effect cats differently. As for high numbers? As Wendy said, they're really not bad. And after a lot of hypo numbers for my own, I came to like them more than the low ones.
I see your Lily (I have one of those too), had a number of issues. Are the steroids for the ibd? I've had way too many ibd (still have 4 currently), and all but 1 were food related. Once I could weed out the offending ingredients, they did great on specialty food. And I don't mean rx food. I won't go on my anti-rx food rant (my vets have had us use almost every available at one point), but I do believe there are always better options with a little research.
I looked at the ingredients of yours, and I didn't even see an animal protein except the chicken fat? I'm sure it's just my bad eyes, but if so that doesn't seem right. Cats being obligate carnivores and all. And that rice can really mess with her glucose. I did also see Lily had ckd, and didn't know if that's why she's on that food. But I've had 4 with kidney failure myself, and when I listened to the newer research about how all cats (including those with renal problems) still need high meat protein, but not plant protein. Here are 2 articles written by veterinarians talking about old myths and new data. Dr. Norsworthy & Dr. Falconer.

Anyhow, had you gone through the typical food allergies cats tend to have, to see if that could help the ibd? Mine are allergic to: Fish, all poultry, and gums. If I can keep all of those out of their food, they do well with eating, solid stool, and no squishy belly sounds gurgling. I know you're a tech and work with doctors, but sometimes something simple can be overlooked, so I thought I'd throw it out there. If it could be controlled with food, sure would make things easier on you both.
And welcome.

Wendy&Neko said:

Most cats will bounce shortly after a large drop or lower number than they are used to. But a few cats, like mine, will sometimes delay the start of a bounce. Bouncing doesn't mean solid high numbers, there can be some wobbling around in numbers.

It's good to show the lowest numbers on the spreadsheet, as we like to know how low the dose can take the cat. With dry food in the picture, you don't want them going any lower than 90 on a dose. You did say that was with the Libre. Have you done side by side comparisons between the Libre and the AT? Often the Libre reads lower in numbers under 100.

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Gotcha. I have seen more “immediate” bounces with her in the past week. But I didn’t really know that they can also be delayed I guess.. which makes thinks quite more confusing.
I do know that lower numbers on the Libre as less accurate. I think at the time I saw that number I was leaving work or driving , it also never registered as a number. I think the lowest it registered at was 110. We were also not home at the time so we couldn’t double check the number. But usually when we double check her FSL lows, AT IS always higher.
I will keep her at 0.75 for few more days then reassess.
I still do worry that 0.75 is not enough for her steroid nights .. which is also tonight

Tyleete said:

I just wanted to remind of one of the mottos since here. Every Cat Is Different. Bounces can act and effect cats differently. As for high numbers? As Wendy said, they're really not bad. And after a lot of hypo numbers for my own, I came to like them more than the low ones.
I see your Lily (I have one of those too), had a number of issues. Are the steroids for the ibd? I've had way too many ibd (still have 4 currently), and all but 1 were food related. Once I could weed out the offending ingredients, they did great on specialty food. And I don't mean rx food. I won't go on my anti-rx food rant (my vets have had us use almost every available at one point), but I do believe there are always better options with a little research.
I looked at the ingredients of yours, and I didn't even see an animal protein except the chicken fat? I'm sure it's just my bad eyes, but if so that doesn't seem right. Cats being obligate carnivores and all. And that rice can really mess with her glucose. I did also see Lily had ckd, and didn't know if that's why she's on that food. But I've had 4 with kidney failure myself, and when I listened to the newer research about how all cats (including those with renal problems) still need high meat protein, but not plant protein. Here are 2 articles written by veterinarians talking about old myths and new data. Dr. Norsworthy & Dr. Falconer.

Anyhow, had you gone through the typical food allergies cats tend to have, to see if that could help the ibd? Mine are allergic to: Fish, all poultry, and gums. If I can keep all of those out of their food, they do well with eating, solid stool, and no squishy belly sounds gurgling. I know you're a tech and work with doctors, but sometimes something simple can be overlooked, so I thought I'd throw it out there. If it could be controlled with food, sure would make things easier on you both.
And welcome.

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Hi thanks for your reply
Yes , you are correct. There is no animal protein in the diet. I have done a lot of CE And also work with a board certified nutritionist that vouches for these diets. They are well formulated and completely balanced. I’ve had my animals on them for many years and they’ve done just fine on them.
Her food is not the issue here. It’s her steroids which is why she became diabetic in the first place. I do know that carbohydrates/dry food does not help the diabetes situation but that’s not what caused her issue nor does it really cause a spike in her. The steroids are what spikes her really high. I am happy with her current diet , unless I decide I want another option I can consult with our nutritionist and see what options I may have
My other boys with IBD also get rabbit and duck wet food which works fine for them. Lily wants their food and I’m sure she would do fine with it as well, but I am preserving that idea until one day she becomes so inappetent that those become an option to get her to eat.
Again, she’s doing well on her food for years so I don’t want to rock the boat right now.
If you saw her numbers when she first got diagnosed You would wonder what kind of diabetic she is lol. Before she developed her most recent pancreatitis, her BGs were actually dropping after she ate , not spiking.

Things have since changed since her pancreatitis which is making things a bit more difficult with her
Thanks again!

I just suggested if it was the food, perhaps she could eat what's better for her and then go off the steroids.

Unfortunately sometimes food is not enough to deal with inflammation. The current food she’s on right now is the best for that. We’ve trying tapering her steroids before with no luck.

My current IBD kitty also cannot go off of steroids, tried tapering, got ileus. The good news (antijinx) is that 7 years of steroids and her BG is still in normal range. We've seen other kitties on high carb dry food become diabetic over time on the high carb food. Hence the questions, and the food being fed to a diabetic does make a huge difference in ability to regulate. Have you ever considered trying budesonide for Lily? It doesn't impact the BG for some cats, it didn't for my girl Neko, but still helped her bowel inflammation.

Yes I know that dry food can cause diabetes in cats , esp overweight ones.
Her food doesn’t really cause her to spike that much as her steroids do. Her current issue right now is the bout of pancreatitis she developed a few weeks ago that made her Stop responding to insulin and stop making her own. She has now become more insulin dependent hence the dose increase.
Her food is currently not that much of an issue. I also just don’t think I can get her to eat all her calories just on wet food - it won’t be possible.
I am not interested in changing her food or steroids at this point as I don’t want to rock any boats with her.
It seems as though you were right about her being in a bounce. She’s been responding well to her insulin since that night and has been pretty stable as of now
So thank you!! I will post my spreadsheet and keep you updated if I need

Wendy&Neko said:

My current IBD kitty also cannot go off of steroids, tried tapering, got ileus. The good news (antijinx) is that 7 years of steroids and her BG is still in normal range. We've seen other kitties on high carb dry food become diabetic over time on the high carb food. Hence the questions, and the food being fed to a diabetic does make a huge difference in ability to regulate. Have you ever considered trying budesonide for Lily? It doesn't impact the BG for some cats, it didn't for my girl Neko, but still helped her bowel inflammation.

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a little off topic as I was reading your sweet Neko’s profile. Did any of your vets inform you that steroids can cause CHF In animals with heart disease ?

DBSG & Lily said:

Did any of your vets inform you that steroids can cause CHF In animals with heart disease ?

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Neko got the CHF from getting fluids given her for her kidney disease. The budesonide was started after she had CHF, and under supervision of a cardiologist vet and IM vet. Both her heart and her kidneys were in bad shape due to her acromegaly. She had been having regular echos before then.

Back to Lily.
It looks like you've grabbed a spreadsheet template from a Facebook group not affiliated with us. This is the link to our template: How to Create a Spreadsheet: Ours is the original format spreadsheet. The FB group that copied ours made some changes and as a result it doesn't load properly on some devices.

The Royal Canin food is high in carbs, so not a great product for a diabetic. Feeding any diabetic cat high carb dry food does make a difference in trying to regulate a cat. For that reason, people feeding high carb dry and wanting to use one of our dosing methods here have to follow the Start Low Go Slow Dosing Method (details on the Lantus forum Sticky Note on Dosing Methods). It's a safety thing. The goal with that method is a dose with nadirs (plural) in the 90-149 range. Glad to see this dose is working better now.

Yea, kidney disease and heart disease unfortunately suck together on top of IBD. What helps the two can damage the other. It’s not a fun game.

Yes I used this spreadsheet from the fb group but I altered it a bit . However, I created my own SS From scratch for 2026 and it took me hours to do( I was trying to do it while I was working ) I’m not creating a new spreadsheet.
I thought your spreadsheets were also Google Docs ?
Also, I’m not changing her diet. I do not think she will get her full calories from eating just wet food as I would have to feed her more food than she’s eating now since wet food is a lot lower in calories. I’m also not sure how novel proteins will work for her. They do work for my other boys with IBD. I’m reserving the wet food for her for emergency situation.
I will do whatever I need to based on what she eats now and what you guys suggest/recommend for dosing.
Just to clarify , I’m not here for diet advice or suggestions. I do understand how dry food/carbs affect diabetics as I am still a tech.

I’m just not up to changing her diet right now.
Just need help understanding Lantus in cats since that’s one thing not one vet has ever explained to me. The problem with being a tech is all the drs assume you just know everything so they fail to go into detail about anything. While I do have a lot of knowledge , sometimes that goes out the window when it comes to us techs treating our own.

Thanks again!

Can you please see if the 2026 sheet I made on my own works

DBSG & Lily said:

Yea, kidney disease and heart disease unfortunately suck together on top of IBD. What helps the two can damage the other. It’s not a fun game.

Yes I used this spreadsheet from the fb group but I altered it a bit . However, I created my own SS From scratch for 2026 and it took me hours to do( I was trying to do it while I was working ) I’m not creating a new spreadsheet.
I thought your spreadsheets were also Google Docs ?
Also, I’m not changing her diet. I do not think she will get her full calories from eating just wet food as I would have to feed her more food than she’s eating now since wet food is a lot lower in calories. I’m also not sure how novel proteins will work for her. They do work for my other boys with IBD. I’m reserving the wet food for her for emergency situation.
I will do whatever I need to based on what she eats now and what you guys suggest/recommend for dosing.
Just to clarify , I’m not here for diet advice or suggestions. I do understand how dry food/carbs affect diabetics as I am still a tech.

I’m just not up to changing her diet right now.
Just need help understanding Lantus in cats since that’s one thing not one vet has ever explained to me. The problem with being a tech is all the drs assume you just know everything so they fail to go into detail about anything. While I do have a lot of knowledge , sometimes that goes out the window when it comes to us techs treating our own.

Thanks again!

Click to expand...

Wendy&Neko said:

My current IBD kitty also cannot go off of steroids, tried tapering, got ileus. The good news (antijinx) is that 7 years of steroids and her BG is still in normal range. We've seen other kitties on high carb dry food become diabetic over time on the high carb food. Hence the questions, and the food being fed to a diabetic does make a huge difference in ability to regulate. Have you ever considered trying budesonide for Lily? It doesn't impact the BG for some cats, it didn't for my girl Neko, but still helped her bowel inflammation.

Click to expand...

Wendy&Neko said:

Neko got the CHF from getting fluids given her for her kidney disease. The budesonide was started after she had CHF, and under supervision of a cardiologist vet and IM vet. Both her heart and her kidneys were in bad shape due to her acromegaly. She had been having regular echos before then.

Back to Lily.
It looks like you've grabbed a spreadsheet template from a Facebook group not affiliated with us. This is the link to our template: How to Create a Spreadsheet: Ours is the original format spreadsheet. The FB group that copied ours made some changes and as a result it doesn't load properly on some devices.

The Royal Canin food is high in carbs, so not a great product for a diabetic. Feeding any diabetic cat high carb dry food does make a difference in trying to regulate a cat. For that reason, people feeding high carb dry and wanting to use one of our dosing methods here have to follow the Start Low Go Slow Dosing Method (details on the Lantus forum Sticky Note on Dosing Methods). It's a safety thing. The goal with that method is a dose with nadirs (plural) in the 90-149 range. Glad to see this dose is working better now.

Click to expand...

I’ve created a 2025 sheet using your template and linked/transferred my data over. I’ve also linked my own 2026 sheet to the NEW 2026sheet(using your template). So now when I enter numbers in my sheets they will transfer over to the new ones(yours)

I’ve updated the new link in my signature

Hope that everything is worked out now if you can check!
Thanks!

I can see your data on the 2025 tab. Thanks for taking the time to do that!

One of the things we probably don't ask enough is what your goals for Lily are. Many members here are hoping for remission from diabetes. As long as you're comfortable with a goal of good regulation we are good with you're feeding Lily however you desire. Most new members come here with a scant understanding of feline diabetes so we tend to be overzealous with providing information.

There are several sticky notes at the top of the Lantus board. If you've not had a chance to look them over, they are a good start for getting a handle on how Lantus works. If you have specific questions, please fire away. We're happy to provide as much information as you need.