Changing Insulins

[Meowsmum]

And I need help.

Meows vet agreed that caninsulin isnt lasting long enough for Meow. IT wears off after 5 hours.

So, he let me try Lantus. And here I thought I would be taking BG the same and dosing based on Pre Shot numbers.

The sticky I read said I was wrong. So now I need help.

Someone please explain to me how to use Lantus. How do I determine how much to give? Do I dose per AMPS or PMPS or only the Nadir numbers? When exactly is the cats nadir?

Should I wait until tomorrow to start it and give him his caninsulin tonight?

I thought I knew what I was doing, but now I feel like I'm walking through another minefeild.

Also, I use the Alpha trak for Meow of that helps. He is just over 6 kgs, up from 5 Kgs.

 

[MommaOfMuse]

Since you are hometesting I would start him on Lantus as soon as possible, but I would only start him off at either .5u or 1u b.i.d. of Lantus, and hold that dose for at least 3 days as it works very different from what you know. It has to build up a shed or depot before it becomes effective. Sort of like filling up a bucket just enough so it doesn't overflow, with each shot you are topping off that bucket from what the cat used the cycle before.

On Lantus his nadir should be right around +6-ish some cats are a little earlier and some a little later. The biggest difference in Lantus is not only the carry over from one shot to the other is consistency...it wants the same dose morning and evening, so you aren't changing doses with every shot, you pick a dose hold it from 3-5 days, then base changes on where the nadir is...

From the Lantus TR-forum

General" Guidelines:

Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).

Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).

Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.

Increasing the dose:

Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose.

After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.

After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.

Reducing the dose:

If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.

If an attempted reduction fails, go right back up to the last good dose.

Try to go from 0.25u to 0.1u before stopping insulin completely.

If you have other questions or need additional help I would suggest posting to the Lantus TR group and they can give you all the help you need.

Mel, Maxwell, Musette & The Fur Gang