Different doses Lantus?

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Hosanna

Hosanna

Member Since 2012
Can we give different dosages of Lantus? For example, Martha's vet yesterday prescribed 2 units. Her BG at that time was 291. I did not give her Lantus until 9pm last night, her BG at that time was 307 and I gave 2 units.
This morning it is 194 and I want to give only 1u. But what if it's over 300 again tonight? Is it ok to give 2 units again?
 
Lantus is a shed or depot insulin, so it is dosed based on the nadir, not on preshots. The nadir is the lowest point of a cycle. A cycle is the 12 hrs between each shot. You will need to get what we call mid cycle tests, where you get a test or two some 4-6 hours after the shot. That way, we know how the insulin is working and can adjust accordingly. For example, if Martha is 300 at her preshot, you give her 2 units, and a few hours later she dives down to 50, you may want to decrease. If you shoot her at 300 and she stays in relatively flat numbers through the cycle, you don't want to decrease.

We don't recommend newbies give shots at all if kitty is under 200. What I would do is do not feed or give insulin, and test her again in 15 or 30 minutes and see if that number is going up. If it is, you can shoot, but I don't feel comfortable giving dose advice. Maybe someone else will.
 
Hi,
Here is a link for the start low, go slow way which is what is recommended for just starting out.

http://binkyspage.tripod.com/SLGS.html

You want to stay on a dose for a few days to see how it's working and not react to a pre-shot number.
However, I don't believe that 2 u is a low enough starting dose.
You need to learn your cats patterns after starting insulin which means you need more bg tests at different times.
You might have a high pre-shot number and then drop low during the cycle, the lows in the middle of the cycle are when
you earn a decrease.

Let me go get some other eyes to tell you what dose you should adjust to for your next shot and then you will want to
keep the amount the same and observe and get lots of bg tests and start learning your cat's pattern.
 
If you have already given the shot, then you should test again at +3 and +6 hours after the shot today. It may takes a couple or more days until you can see what this dose does, and it could be that you will need to reduce.
If you haven't shot yet, then you could start with one unit. It's your choice. If you do that, you should stick with the dose and get tests in between and just before shots. Lantus needs to be dosed consistently to work correctly.
Carl
 
That's exactly what it means. HOWEVER, without seeing any test values for your cat, I am very apprehensive about giving any dose advice. You've noted two pre-shot test values and no mid-cycle tests. Lantus dosing is based on the lowest point in the cycle (the nadir). I have no way of knowing if giving even 1.0u is safe.
 
Sienne, I am being told not to give her Lantus if the BG falls below 200. Here are her readings for today:
9 am pre-shot -194
1 unit Lantus insulin
All morning she had only Fancy Feast wet food.
2 pm - 137
I am at this moment letting her have some Hills M/D Dry, about 1/16th of a cup.
Will follow up around 9 pm tonight.
 
Hi again,

It would be very helpful if you could get a spreadsheet started so that everyone has a reference to your numbers.
I think someone said that to you already in a different thread but here is the link again.
http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

If you have troubles setting it up, there are those here who can help you do it .( with a temporary password )
Just ask and someone will jump in .


You also have many threads/different subject posts going and it's harder for us to follow you and you may be getting
unconnected answers.
It is generally better to have one posting a day , you can always edit the subject if you want to change the question ...
you go back to the original post. scroll to the bottom where you put your first post and find the edit button. You can
change the subject there and we will all see a new question ..... such as " time for shot, need help"

There are some times when no one is around to answer so you won't always get a quick response. It's better to ask a question
earlier and give it time for other's to see.


Having all the information together in a spreadsheet and in a profile will help others like Sienne see all the info on your cat
without having to go hunt it all down in other posts. confused_cat
 
Hosanna

I actually posted this a couple hours ago so I'm not sure why it's not showing up. So I'll repost...

Many of us using Lantus follow a Tight Regulation Protocol. HOwever, one of the requisites to following that protocol is that the cat be eating a low carb, canned or raw food. The no shoot number for new members following TR is 150; however, by feeding dry food, you have a more limited toolbox to deal with low numbers if they were to occur. Dry food takes a long time to bring low numbers up and then stays in the system a while therefore keeping numbers high longer than canned or raw food would.

Lantus likes consistency.....shooting every 12 hours with the same dose (unless a reduction is earned or the dose needs to go up) as much as possible will help keep the numbers from getting too wonky. Shooting different doses or skipping shots repeatedly will make numbers wonky. When we can see a SS and a caregiver has built some data, we can help that CG to learn how to shoot lower and lower. As Ry said, we primarily dose on the nadir, not the PS so even if you get a really high number at PS and are wanting to give more insulin than what she is supposed to get, you just have to hold the dose until we know if the nadir warrants the dose going up.

As Rhiannon suggested, we really need a Spreadsheet in order to help you figure the correct dose for Martha. If there is any way for you to do it before you shoot tonight, we could help you. If you need any help, PM me. It's very difficult for us to know if she is at a good dose with just a few numbers mentioned here and there.

I know this is all overwhelming and the learning curve is steep but we are happy to help in any way we can but our first priority is helping you keep her safe.

eta: on testing...be sure that the bevel of the lancet is UP; that way the sharpest part of it is going in first. And poke at an angle....not straight down. I keep a cold, damp baby washcloth ready and as soon as I poke and test, I put pressure on the pokey site with the washcloth to keep it from bleeding and bruising. Then I put Neosporin Ointment (not cream) with Pain Relief on her ear where I poked...every single time. You do have to wipe it off before the next poke. I also alternate ears...we keep a note pad and keep track of which ear. My vet cannot believe how wonderful Gracie's ears look...she would have never guessed we hometest (if she didn't know) much less as much as we do.
 
I have so many posts because it was suggested to me to do that. I was not getting responses as I'd hoped, so this person told me to start new topics instead of staying in the same thread.
And yes! Please, I do need help, if someone could set up the spreadsheet for me. Please? What do I have to do about passwords?
 
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