Hi all
Phew managed to get in here somehow! I think I have previously posted an intro.
Following the recent trauma with Bailey being overdosed on Lantus insulin on advice of intern vet of how much to pull on new syringe Bailey is ok.
Have been advised to shoot 1.5 units if BG is above 5 and 1 unit if BG below 5.
For the past few days I have been testing first thing in the morning before breakfast and 12 hrs later.
Results are:
28 May Morning 23.3
27 May Morning 23.4 Evening 23.3
26 May Morning 3.8 Evening 27.7
25 May Morning 32.3 Evening 26.9
24 May Morning 31.5
23 May 26.9 Evening 29.9
When he was on 1 unit
The first BG curve I did was: 07:30 hours 29.1 then every 2/3 hrs 32.2. 28.1. 31.8. 29.9. 23.7
I am doing his 2nd curve tomorrow. He is now on 1.5 units. I have to let the University of Liverpool Small Animal Hispital know the results.
Your comments would be appreciated please,
I know the BG is reading high. He was 38.0 when first diagnosed with FD Ketoacidosis and Pancreatitis.
We find that Lantus does best when given in equal doses every 12 hours, as there is a small amount of overlap between doses. When you shoot earlier, there is more overlap which may lower levels a bit more; conversely, when you shoot later, there is less overlap which may allow levels to rise a bit more. Lantus doses take a while to stabilize as the effect of the overlap, or depot, build. Starting out, that may take 5-7 days. After that, it may take 3-5 days for the dose to have a stable effect.
We have 2 methods used here to manage Lantus dosing in cats: Tight Regulation Start Low, Go Slow - if feeding any dry food, this is the one to follow
Lantus doses are adjusted based on how low the glucose goes, so snagging a test when that is likely to happen is really important. This low point, or nadir, is generally in the +5 to +7 hours post-shot. With Start Low, Go Slow, after a week of the same dose and a curve where you test every 2 hours for 12 hours, if nadir period tests are above 8.3 mmol/L (150 mg/dL), you may raise the dose 0.25 units (eyeballed). With Tight Regulation, after 3 days with mid-cycle tests and nadirs above 8.3 mmol/L (150 mg/dL), 8.3 mmol/L (150 mg/dL).
Because your cat has had diabetic ketoacidosis (DKA), we strongly encourage urine glucose testing with urine ketone test strips available online or at many pharmacies. There are some tips on doing this in my signature link Secondary Monitoring Tools. If you can get a blood ketone meter, that will give you a warning of ketones earlier than urine testing.
Please come over to the Lantus/Levemir section to read all the sticky posts on using Lantus optimally.
When you have a moment, could you add a few tidbits to your signature? It will help us give you feedback.
Editing your Signature
In the upper right corner of the screen, within the dark blue bar, you will see ID, Inbox, and Alerts
Click on your ID.
On the left, under Settings, Click on Signature.
This is where you will put information that helps us give you feedback. You are limited to 2 hard returns, so separate pieces by | or -.
This is where you paste the link for your spreadsheet, once it is set up.
Add any other text, such as your name | cat's name | date of Dx (diagnosis) | insulin | meter general location (city and state/province) any other pertinent issues like if there are any food issues, history of DKA, hepatic lipidosis, pancreatitis, allergies, IBD, etc.
The last couple of nights I have been monitoring the amount he drinks. 140-150mls. Quarter pint. Is that a lot?
He is mostly on wet food now but for his times insulin shots I sometimes have to add some Thrive biscuits just so he has enough food in him.
I've ordered some more strips for the meter as I'm running low having been testing this week before each shot. Numbers still high, just one weird dramatic drop to 3.8 one morning. Otherwise between 22.8 and 32.3
We find that Lantus does best when given in equal doses every 12 hours, as there is a small amount of overlap between doses. When you shoot earlier, there is more overlap which may lower levels a bit more; conversely, when you shoot later, there is less overlap which may allow levels to rise a bit more. Lantus doses take a while to stabilize as the effect of the overlap, or depot, build. Starting out, that may take 5-7 days. After that, it may take 3-5 days for the dose to have a stable effect.
We have 2 methods used here to manage Lantus dosing in cats: Tight Regulation Start Low, Go Slow - if feeding any dry food, this is the one to follow
Lantus doses are adjusted based on how low the glucose goes, so snagging a test when that is likely to happen is really important. This low point, or nadir, is generally in the +5 to +7 hours post-shot. With Start Low, Go Slow, after a week of the same dose and a curve where you test every 2 hours for 12 hours, if nadir period tests are above 8.3 mmol/L (150 mg/dL), you may raise the dose 0.25 units (eyeballed). With Tight Regulation, after 3 days with mid-cycle tests and nadirs above 8.3 mmol/L (150 mg/dL), 8.3 mmol/L (150 mg/dL).
Because your cat has had diabetic ketoacidosis (DKA), we strongly encourage urine glucose testing with urine ketone test strips available online or at many pharmacies. There are some tips on doing this in my signature link Secondary Monitoring Tools. If you can get a blood ketone meter, that will give you a warning of ketones earlier than urine testing.
Please come over to the Lantus/Levemir section to read all the sticky posts on using Lantus optimally.
When you have a moment, could you add a few tidbits to your signature? It will help us give you feedback.
Editing your Signature
In the upper right corner of the screen, within the dark blue bar, you will see ID, Inbox, and Alerts
Click on your ID.
On the left, under Settings, Click on Signature.
This is where you will put information that helps us give you feedback. You are limited to 2 hard returns, so separate pieces by | or -.
This is where you paste the link for your spreadsheet, once it is set up.
Add any other text, such as your name | cat's name | date of Dx (diagnosis) | insulin | meter general location (city and state/province) any other pertinent issues like if there are any food issues, history of DKA, hepatic lipidosis, pancreatitis, allergies, IBD, etc.
