12/31/22 Henry AMPS 500 maintain Lantus dose?

[Henry’s Mom]

Good day! Henry started Lantus yesterday, having switched from Vetsulin. His AMPS today was 500. I gave his 0.1 unit after breakfast. Do I maintain the 0.1 unit dosage? Thank you for any insight! Also,
Happy New Year from our motley crew (Henry, Hailey, Spicy the cats, and Max the dog )

 

[Sienne and Gabby (GA)]

I would hold the dose.

Lantus works very differently than Vetsulin. These are a few of the important differences:

• Vetsulin is what we refer to as an "in and out" insulin. You give a shot and the insulin is metabolized within the cycle or for many cats, usually in 8 to 10 hours. With Lantus, when you give a shot, the insulin forms microcrystals that are deposited in the fat tissue. Those crystals mostly dissolve over the course of the cycle. A little bit remains to form what is referred to as the "depot." The depot allows for overlap between doses and helps give Lantus its longer duration.
• When starting Lantus, it takes 5 - 7 days for the depot to form and stabilize.
• Another difference between the two types of insulin is that you don't want to make back-to-back changes in the dose. Because it takes a few days for the depot to stabilize once you're past the first week, if you make rapid changes in the dose, you can get wonky numbers. (With Vetsulin, since there's no depot, you can make those changes.) There are times when those changes may be necessary but it can be important to know what to expect.
• The other difference is that Lantus dosing is based on the nadir. The pre-shot test tells you if it's safe to give insulin. The nadir (lowest point in the cycle) informs your decision to raise or lower the dose.

You may want to take a look at the sticky notes at the top of the Lantus board. I'd encourage you to read over the information on dosing methods since at some point soon, you'll want to decide whether you want to follow Tight Regulation (TR) or Start Low Go Slow (SLGS). There's also a sticky pertaining to the depot.

 

[Henry’s Mom]

Thank you so much for the detailed info @Sienne and Gabby (GA)! I did not realize how different the two insulins were. So after 5-7 days, is that when the action of the current dose will become apparent, such as a better idea of the nadir? Thank you

 

[Sienne and Gabby (GA)]

What you see for this initial period is likely not what will be happening once the depot stabilizes. There may be an indication of what will happen but don't think it's the gospel.

Having made that statement, we can both wait for Henry to prove me wrong! There are two things I learned using Lantus. #1 - patience. #2 - cats do not like to be predictable.

 

[Henry’s Mom]

What you see for this initial period is likely not what will be happening once the depot stabilizes. There may be an indication of what will happen but don't think it's the gospel.

Having made that statement, we can both wait for Henry to prove me wrong! There are two things I learned using Lantus. #1 - patience. #2 - cats do not like to be predictable.

Thank you! Very helpful and good to know what expect (or not expect lol). Thank you

 

[Bron and Sheba (GA)]

Hi Kay, I agree with all Sienne has said. And the 0.1 dose is taking Henry down to blue BGs which is pretty good for the second day on Lantus.
Kay, in the SS you have written that you are giving 0.5 units of Lantus but you say above that you are giving 0.1 units (that we advised you to give.)
Did you make an error on the SS?

 

[Henry’s Mom]

Hi Kay, I agree with all Sienne has said. And the 0.1 dose is taking Henry down to blue BGs which is pretty good for the second day on Lantus.
Kay, in the SS you have written that you are giving 0.5 units of Lantus but you say above that you are giving 0.1 units (that we advised you to give.)
Did you make an error on the SS?

Hi there, yes my SS was incorrect - I have been giving the 0.1 since yesterday. I have fixed the entries. Thank you for catching that.