Hi everyone,
Happy Sunday!
It's my first post here, after the reading the forum quite extensively the past month following our cat Boots' (15 y/o) diabetes diagnosis mid-January. We're hoping to receive your advice on how best to proceed with our dosing after seeing some fluctuating responses to Lantus.
Our key challenge is inconsistent responses to the same dose - sometimes 1 unit causes dangerous lows, other times it barely affects his high numbers. We have a CGM and continuous monitoring at home. Our vet has been incredibly supportive and helpful with his diagnosis, but we realise they have a limited depth of expertise when it comes to diabetes, so this forum has already been such a great resource for us starting this journey. You can find below a summary of Boots' treatment so far:
Insulin History:
As he is only just over a week into his Lantus treatment (1 month total on insulin treatment), is this just bouncing we are seeing? Is it unusual that the same dose that doesn't really seem to have an impact during the bounce, can then drop his glucose very low once it clears? We're conscious his glucose is generally very high, so although he appears much better in himself vs prior to his insulin treatment, we don't want to delay in getting the dose correct as soon as possible. Any guidance would be greatly appreciated, especially regarding dose adjustment strategy. We're committed to getting this right but feeling stuck with the unpredictable responses.
His spreadsheet should be in the signature.
Thank you!
Happy Sunday!
It's my first post here, after the reading the forum quite extensively the past month following our cat Boots' (15 y/o) diabetes diagnosis mid-January. We're hoping to receive your advice on how best to proceed with our dosing after seeing some fluctuating responses to Lantus.
Our key challenge is inconsistent responses to the same dose - sometimes 1 unit causes dangerous lows, other times it barely affects his high numbers. We have a CGM and continuous monitoring at home. Our vet has been incredibly supportive and helpful with his diagnosis, but we realise they have a limited depth of expertise when it comes to diabetes, so this forum has already been such a great resource for us starting this journey. You can find below a summary of Boots' treatment so far:
Insulin History:
- ProZinc from Jan 14 - Feb 14 (1-3 units 2x per day, varying according to vet advice)
- Switched to Lantus on Feb 14 (due to broken ProZinc vial + shortage of it in our area) starting at 1u
- Currently on Lantus 1u 2x per day
- Very unstable control
- Frequent highs and lows
- Difficulty finding stable dose
- Minimal time in green zone
- Started Feb 14 at 1u (Boots current weight 4.35 kg)
- Initial response looked promising with gradual blood glucose decrease
- Feb 16 AM: Held dose due to green zone AMPS, resulted in severe low nadir which required honey, followed by dramatic rebound afterwards
- Reduced to 0.75u PM dose after the low nadir
- Maintained 0.75u for 6 cycles but remained persistently high
- Feb 19 PM: Increased back to 1u
- Experienced very low overnight nadir requiring honey, followed by a subsequent bounce back to high results
- Currently remaining very high on 1u again for the past few cycles
- Low-carb wet food only
- Fed 6x daily: 7:30AM (with first shot), 10AM, 2PM, 5PM, 7:30PM (with second shot), 11PM
- Amodip (0.625mg)
- Bennefortin (2.5mg)
- Both given with AM shot in pill paste
- Boots is clinically doing well and hugely improved vs before his diagnosis
- Normal appetite
- Playing and interactive
- Gaining weight back following loss prior to diagnosis
- No concerning behavior changes
- 1u seems too much sometimes (causing very low lows) but ineffective at other times (persistent highs)
- Unsure whether to continue holding, increase, or decrease dose
As he is only just over a week into his Lantus treatment (1 month total on insulin treatment), is this just bouncing we are seeing? Is it unusual that the same dose that doesn't really seem to have an impact during the bounce, can then drop his glucose very low once it clears? We're conscious his glucose is generally very high, so although he appears much better in himself vs prior to his insulin treatment, we don't want to delay in getting the dose correct as soon as possible. Any guidance would be greatly appreciated, especially regarding dose adjustment strategy. We're committed to getting this right but feeling stuck with the unpredictable responses.
His spreadsheet should be in the signature.
Thank you!
