Cookee and her caregiver:
Until you have a spreadsheet and get the hang of how we do things here, we ask that you post in Health. There's a huge learning curve and the assumption on the insulin-specific boards is that you have the basics down. I suspect the learning curve isn't too overwhelming if you're working in health care so once you get a spreadsheet set up and we have some other information, it will be fine to move back over to the Lantus board.
A couple of thoughts. We do ask that you try to get as many tests in as possible. There are many people here who work and/or go to school and have obnoxious commutes and have to juggle those responsibilities with caring for their kitty. I would suggest that you get at least a "before bed" test every night so you can go to sleep without worrying about whether there's a drop in your cat's blood glucose (BG) numbers. We tend to get a bit pushy about testing especially since Lantus dosing is based on the nadir. Since you can't be at home to catch the AM nadir, it's important to get some PM tests to offset what may be missing during the day.
You may want to think about making sure food is available at night as well as the day time snack. Many people here use a timed feeder if you're not already using one.
In addition to the link that Bron provided, this is
information on getting started. The information on spreadsheets, setting up your signature, what to have in a hypo kit, etc are in the post.
You haven't mentioned what you're feeding your cat. Would you mind filling us in on what your cat is eating?
You mentioned a few items in your post on the Lantus board. There are
two dosing methods we use with Lantus -- Start Low Go Slow (SLGS) and Tight Regulation (TR). While the methods vary in how long you hold a dose, the longest a dose is held is generally a week. It's not surprising that your cat's numbers may have gone up since it's unlikely that the same dose is going to provide consistent results over a long period of time. We also adjust doses in 0.25 increments. Given the limitations of your schedule, increasing by a smaller amount than the 0.5u you mentioned is safer and as a general rule, it prevents you from zooming past what would be a good dose.
As for Somogyi, it really has not been proven to exist in cats. The original concept was first mentioned in 1938 by Michael Somogyi who published a study involving 8 humans. He was also using a fast acting insulin. The paper was published in a local medical journal. It seems to be a concept that should have never gotten any attention since his results could never be replicated in humans, let alone in cats. One of the premier feline vets who developed the Tight Regulation Protocol for Lantus and Levemir looked at data she collected and could not document the existence of Somogyi in cats prescribed glargine.
