11/10 ? Dosing Lantus question

[Amy and Django]

2 weeks ago we switched from Caninsulin to Lantus. After the 1st dose at 1.25 Django's numbers dropped and I couldn't administer a pm dose. So the next day I dropped down to 1u 2x a day and maintained that for almost a week. At that dose he was constantly hovering between 17 (308) and 24 (432) and so I upped it to 1.25. Still no change after a few days. So now I have him at 1.5u twice a day and his numbers are still steady between 17 (308) and 21 (378). I am getting discouraged! I know the depot takes time but is this normal? Do I stay at 1.5u or do something different? Did I increase the dose too fast? I feel horrible keeping him at such high numbers all the time! https://docs.google.com/spreadsheet...vsCr7jXqgzsmo7UDvYIO4jR9riE/edit?usp=drivesdk

 

[Annie & Kozmo]

Hi Amy, found you from your FB post. As I mentioned I’m not qualified to give advice and I have no idea how long you’ve been here on the FDMB.... sometimes adding a big blue ? to your subject line attracts attention from those who know much more than me!

What I can say is that Kozmo loves Lantus and our fight with the vet to change from Caninsulin has been life-changing for him.

Hoping someone can answer your question soon xxxx

 

[tiffmaxee]

Welcome. Please read the yellow sticky and choose a dosing method. What are you feeding ? How often? Let me look at your spreadsheet. Be right back. Did you post an intro on the main forum? That’s where you are supposed to start. You need to get a test before every injection. On the night of 10/8 he dropped into yellow. He might have gone lower. I would have gotten another test in an hour.

Also read all tge yellow stickies but dosing first as that determines dosing advice given here.

 

[Katie_Waz]

2 weeks ago we switched from Caninsulin to Lantus. After the 1st dose at 1.25 Django's numbers dropped and I couldn't administer a pm dose. So the next day I dropped down to 1u 2x a day and maintained that for almost a week. At that dose he was constantly hovering between 17 and 24 and so I upped it to 1.25. Still no change after a few days. So now I have him at 1.5u twice a day and his numbers are still steady between 17 and 21. I am getting discouraged! I know the depot takes time but is this normal? Do I stay at 1.5 or do something different? Did I increase the dose too fast? I feel horrible keeping him at such high numbers all the time! https://docs.google.com/spreadsheet...vsCr7jXqgzsmo7UDvYIO4jR9riE/edit?usp=drivesdk

I'm new here and not really qualified to answer your question either but I would do as suggested above...put that blue questing mark in your title, finish up your profile and choose a dosing method. It can always be changed later. Read all the stickly... especially about dosing, TR and SLGS.

I might put in my title something like...help...is 1.25 units too much or too little
Or new... need help with dosing

 

[Wendy&Neko]

First off, we suggest, regardless of dosing methods, that you get a test before every shot. That preshot test will tell you if it's safe to give insulin. You really need to decide which dosing method you want to use, as we need that information to help you about dosing. You are increasing as fast as Tight Regulation, but not with the amount of testing it requires. Feline diabetes is a marathon, not a sprint. Patience is your friend.

Second, some cats have an initial reaction to a change in insulin, but then that reaction "poops out". When you started Lantus, you got some nice numbers, there wasn't really a reason to reduce.

 

[Amy and Django]

Welcome. Please read the yellow sticky and choose a dosing method. What are you feeding ? How often? Let me look at your spreadsheet. Be right back. Did you post an intro on the main forum? That’s where you are supposed to start. You need to get a test before every injection. On the night of 10/8 he dropped into yellow. He might have gone lower. I would have gotten another test in an hour.

Also read all tge yellow stickies but dosing first as that determines dosing advice given here.

 

[Amy and Django]

Thanks for your response. I feed canned and raw twice a day with his shot with freeze dried.chicken treats after testing. I have trouble getting preshot readings because he squirms so much when he's eager to eat. I wanted to do the SLGS method but I guess I got too freaked out by the high numbers and modified dosage too quickly. I will be sure to post an intro in the forum. I have read the stickys but I think I need to reread... so much info and I think I forget as much as I retain.

 

[Annie & Kozmo]

Thanks for your response. I feed canned and raw twice a day with his shot with freeze dried.chicken treats after testing. I have trouble getting preshot readings because he squirms so much when he's eager to eat. I wanted to do the SLGS method but I guess I got too freaked out by the high numbers and modified dosage too quickly. I will be sure to post an intro in the forum. I have read the stickys but I think I need to reread... so much info and I think I forget as much as I retain.

Do stick with us, Amy. You’re in good hands here xxxx

 

[tiffmaxee]

There’s a lot to learn and we will help you. Most feed several small meals as it helps to steady the bg. We just pick up the food two hours before dosing so the preshots aren’t food influenced. That way it will be easier to get the test as he won’t be starving. The appetite will come down once he’s controlled. How’s his weight? Too high, too low, or ideal? If underweight he needs to eat more. You can give a few treats as you test. That might help. As stated it’s a marathon fir most rather than a race and the cats determine what we do and not the other way around.

 

[tiffmaxee]

Do stick with us, Amy. You’re in good hands here xxxx

I haven’t seen you post recently and just looked at your spreadsheet and see why. I hope you have recovered from your surgery and are well.

 

[Amy and Django]

There’s a lot to learn and we will help you. Most feed several small meals as it helps to steady the bg. We just pick up the food two hours before dosing so the preshots aren’t food influenced. That way it will be easier to get the test as he won’t be starving. The appetite will come down once he’s controlled. How’s his weight? Too high, too low, or ideal? If underweight he needs to eat more. You can give a few treats as you test. That might help. As stated it’s a marathon fir most rather than a race and the cats determine what we do and not the other way around.[/Q

I haven’t seen you post recently and just looked at your spreadsheet and see why. I hope you have recovered from your surgery and are well.

His weight is good and relatively stable at 11 or 12 lbs. He has a great appetite but feeding several small meals is difficult because of my work schedule ( i feed first thing in the morning and when I come home it's already less than 2 hours before his pm feeding and shot.) I also have a second greedy cat so leaving food out is difficult!

 

[Amy and Django]

Hi Amy, found you from your FB post. As I mentioned I’m not qualified to give advice and I have no idea how long you’ve been here on the FDMB.... sometimes adding a big blue ? to your subject line attracts attention from those who know much more than me!

What I can say is that Kozmo loves Lantus and our fight with the vet to change from Caninsulin has been life-changing for him.

Hoping someone can answer your question soon xxxx

I have been able to test a lot lately as I am working from home waiting for a covid test result. Otherwise I am not home.to test during the day except on the weekend.

 

[Annie & Kozmo]

I haven’t seen you post recently and just looked at your spreadsheet and see why. I hope you have recovered from your surgery and are well.

Thanks Tiff, it’s been tougher than we thought but Kozmo’s been a trooper and though we haven’t been able to do mid/testing (pretesting is a religion in our house) he’s cruising. xxx

 

[Sienne and Gabby (GA)]

I have a couple of thoughts...

Like Wendy said, the preshot test is essential. Without it, you have no idea if you're shooting in the 300s or in the 30s. Since Django is squirming, would you consider getting a timed feeder. You could leave a small snack for your kitty at +9 which might help to take the edge off Django's hunger. If worse comes to worse, a freeze dried treat or two might also work at shot time. The other advantage of a timed feeder is that once you're back at work, there will be a way to leave food out for your kitty.

Many of the people here, myself included, work full time. I was able to adjust my shot time to 5:00 so I was able to get a couple of tests before I left the house. (My cat had an early nadir so this worked out well for us.) Shifting your shot time may not be possible for you. If not, get a test before you're out the door and as soon as you're home. It will also make getting tests during the PM cycle even more important. It looks like you've already been getting some PM tests. With TR, you will need to do what you can to get a pre-shot test and at least one test each cycle (work notwithstanding). A before bed test every night is what I typically recommend unless your cat's curve dictates otherwise.

Just to double check, I'm hoping you're using U100 syringes. Caninsulin syringes are U40s.

Caninsulin is quite different than Lantus. I'd encourage you to look over the sticky that describes the depot. With Lantus, as you've already surmised, we hold the dose for a specific period depending on which dosing method you select. It's important to be attentive to holding the dose since rapid changes in the dose disrupts the depot and you need to give the depot a chance to stabilize.

 

[Amy and Django]

I have a couple of thoughts...

Like Wendy said, the preshot test is essential. Without it, you have no idea if you're shooting in the 300s or in the 30s. Since Django is squirming, would you consider getting a timed feeder. You could leave a small snack for your kitty at +9 which might help to take the edge off Django's hunger. If worse comes to worse, a freeze dried treat or two might also work at shot time. The other advantage of a timed feeder is that once you're back at work, there will be a way to leave food out for your kitty.

Many of the people here, myself included, work full time. I was able to adjust my shot time to 5:00 so I was able to get a couple of tests before I left the house. (My cat had an early nadir so this worked out well for us.) Shifting your shot time may not be possible for you. If not, get a test before you're out the door and as soon as you're home. It will also make getting tests during the PM cycle even more important. It looks like you've already been getting some PM tests. With TR, you will need to do what you can to get a pre-shot test and at least one test each cycle (work notwithstanding). A before bed test every night is what I typically recommend unless your cat's curve dictates otherwise.

Just to double check, I'm hoping you're using U100 syringes. Caninsulin syringes are U40s.

Caninsulin is quite different than Lantus. I'd encourage you to look over the sticky that describes the depot. With Lantus, as you've already surmised, we hold the dose for a specific period depending on which dosing method you select. It's important to be attentive to holding the dose since rapid changes in the dose disrupts the depot and you need to give the depot a chance to stabilize.

Yes, using u100 syringes. Thank you for the detailed information. I was focusing more on trying to nail down nadir and was neglecting the preshot readings. Will get on top of that as of today!

 

[Ale & Bobo & Minnie (GA)]

I have another suggestion. Minnie is the same way in the mornings. There’s no way I’d be able to get a test if I didn’t feed her first. So I feed her and then immediately after I test her. That means that within 5 minutes of eating she gets tested and I know the food hasn’t had time yet to affect her bg. This will only work if you know for sure you’ll be able to get that test done within 10 minutes of feeding max. Any longer and you risk the food influencing the bg. It’s become our routing. As soon as she eats she goes over to her testing spot because she knows she’ll get another treat after so it’s a win win in the mornings for her. The other test times are not an issue and I can easily test before feeding her

 

[Amy and Django]

I have another suggestion. Minnie is the same way in the mornings. There’s no way I’d be able to get a test if I didn’t feed her first. So I feed her and then immediately after I test her. That means that within 5 minutes of eating she gets tested and I know the food hasn’t had time yet to affect her bg. This will only work if you know for sure you’ll be able to get that test done within 10 minutes of feeding max. Any longer and you risk the food influencing the bg. It’s become our routing. As soon as she eats she goes over to her testing spot because she knows she’ll get another treat after so it’s a win win in the mornings for her. The other test times are not an issue and I can easily test before feeding her

Great idea! I think I can get a PMPS reading relatively easily, but this technique could work well in the morning. Gonna give it a try tomorrow!