Doctor Orders Once/Day Dose

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Kathleen Tyrrell

Kathleen Tyrrell

Member Since 2019
Sabu has been ordered one unit lantus once each day/ 24 hour cycle, but I'm worried because his last two blood sugar readings are high. You can see his history on his spreadsheet, but I am hoping this is normal. Please advise, I understand the Doctor does not want to perpetuate a 'Somogyi Effect', and perhaps I just need reassurance that this is a normal process in the treatment of newly diagnosed sugar kitty.
 
FurBabiesMama said:
It is not normal to give insulin only once a day to a cat. Normal dosing is twice per day (every 12 hours).

If you have not already done so, I would suggest you head over to the glargine forum: http://www.felinediabetes.com/FDMB/forums/lantus-basaglar-glargine-and-levemir-detemir.9/ There are posts at the top that give info related to the insulin, and that is a good place to post for insulin-specific questions.
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Thank you, I am thinking we need a new Doctor ASAP. I'm very upset about this.
 
Kathleen Tyrrell said:
Thank you, I am thinking we need a new Doctor ASAP. I'm very upset about this.
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Hi,

I just wanted to mention since I saw your post. My vet also recommended starting at one unit once a day (her reasoning was to start with a lower dose, but then why not just cut the dose in half and give half at each 12 hours, makes more sense) and then she said after a week then she changes to twice a day. I had done research here and when I started my cat, I did 2 times a day (12 hours) without telling my vet.

If your vet is meaning to permanently have cat on once a day, then definitely they are not familiar with proper dosing and how this insulin works best for cats. If they are suggesting for just first week like mine did, you can get around that with some help here or show the vet the data from experts that suggest best to do twice a day, or just don’t tell them..

The starting dose can depend on cats weight and what food they are on, if already on low carb food, the starting dose is a little lower. Definitely good info for this over on Lantus (glargine) forum.
 
Julie and Honey said:
Hi,

I just wanted to mention since I saw your post. My vet also recommended starting at one unit once a day (her reasoning was to start with a lower dose, but then why not just cut the dose in half and give half at each 12 hours, makes more sense) and then she said after a week then she changes to twice a day. I had done research here and when I started my cat, I did 2 times a day (12 hours) without telling my vet.

If your vet is meaning to permanently have cat on once a day, then definitely they are not familiar with proper dosing and how this insulin works best for cats. If they are suggesting for just first week like mine did, you can get around that with some help here or show the vet the data from experts that suggest best to do twice a day, or just don’t tell them..

The starting dose can depend on cats weight and what food they are on, if already on low carb food, the starting dose is a little lower. Definitely good info for this over on Lantus (glargine) forum.
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The vet said just for starters b/c she was concerned about the 151 BL the one day, but Sabu's dad and I were just talking and reading the boards and thinking we will follow the advice here and do twice a day without telling and also if we get another low reading do some follow up readings to make sure it's not just a bad reading - dad and I also agree that we need to do more BL's to get a curve and we need to keep things as consistent as possible to optimize Sabu's chances of remission. I am so emotional right now I just want to get some sleep, but we are giving him his AM dose after the BL and continuing BID. Thank you so much for your reply we really appreciate your information and experience <love and hugs from us>
 
Kathleen Tyrrell said:
The vet said just for starters b/c she was concerned about the 151 BL the one day, but Sabu's dad and I were just talking and reading the boards and thinking we will follow the advice here and do twice a day without telling and also if we get another low reading do some follow up readings to make sure it's not just a bad reading - dad and I also agree that we need to do more BL's to get a curve and we need to keep things as consistent as possible to optimize Sabu's chances of remission. I am so emotional right now I just want to get some sleep, but we are giving him his AM dose after the BL and continuing BID. Thank you so much for your reply we really appreciate your information and experience <love and hugs from us>
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I don’t see Sabu’s weight and current type of food in signature. If he is a bigger kitty and still on high carb food, usual starting dose is 1 unit BID.

If you are transitioning to low carb food that needs to be done gradually because the food switch alone can easily drop them by a good 75-100 points! There is guidance on the site on how to transition while keeping the cat safe and adjusting dosing if needed in conjunction with the food change.

You’ll get there:)
 
When M'row got first diagnosed Jan. 1st this year I did a lot of reading about Lantus, which he's on. Consensus is that people take it once/24 hours and cats take it every 12 hours. My glucose curves on him agree with this every 12 hours dosing. Hugs!
 
If you want something other than 'strangers on the internet' to indicate that dosing should be twice per day, the AAHA guidelines have info on insulin dosing: https://www.aaha.org/guidelines/diabetes_guidelines/insulin_therapy.aspx Their starting dose recommendations for glargine (and every other insulin) are twice per day. For glargine:
Cats
0.5 U/kg q 12 hr if BG > 360 mg/dL.
0.25 U/kg q 12 hr if BG < 360 mg/dL.

If you have concerns about going to 1u twice per day, you could do 1/2 unit twice per day. That way, you are giving the vet's recommended dose (and the AAHA recommendation if cat is >360 to start), just breaking it up into two shots instead of giving it in one. :cat:
 
Just a note Gargline (Lantus) was designed as a long lasting insulin for humans and humans do use it on a once a day basis, but cat's metabolism is faster than human metabolism (and dogs metabolism) which is the mainreason cats need insulin twice a day
 
Amina&M'row said:
When M'row got first diagnosed Jan. 1st this year I did a lot of reading about Lantus, which he's on. Consensus is that people take it once/24 hours and cats take it every 12 hours. My glucose curves on him agree with this every 12 hours dosing. Hugs!
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Thank you, I talked with the Doctor today and she agreed to go back to bid injections (every twelve hours) and try a 0.50 unit once leaving the other dose at 1 unit if the BL drops again, so we are about to do his BL now and give his second dose of 1 unit.
 
FurBabiesMama said:
If you want something other than 'strangers on the internet' to indicate that dosing should be twice per day, the AAHA guidelines have info on insulin dosing: https://www.aaha.org/guidelines/diabetes_guidelines/insulin_therapy.aspx Their starting dose recommendations for glargine (and every other insulin) are twice per day. For glargine:
Cats
0.5 U/kg q 12 hr if BG > 360 mg/dL.
0.25 U/kg q 12 hr if BG < 360 mg/dL.

If you have concerns about going to 1u twice per day, you could do 1/2 unit twice per day. That way, you are giving the vet's recommended dose (and the AAHA recommendation if cat is >360 to start), just breaking it up into two shots instead of giving it in one. :cat:
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That is excellent, thank you for that, and you are not strangers, you are my new best friends and I love you all. We will be reading everything recommended as well.
 
Julie and Honey said:
Hi,

I just wanted to mention since I saw your post. My vet also recommended starting at one unit once a day (her reasoning was to start with a lower dose, but then why not just cut the dose in half and give half at each 12 hours, makes more sense) and then she said after a week then she changes to twice a day. I had done research here and when I started my cat, I did 2 times a day (12 hours) without telling my vet.

If your vet is meaning to permanently have cat on once a day, then definitely they are not familiar with proper dosing and how this insulin works best for cats. If they are suggesting for just first week like mine did, you can get around that with some help here or show the vet the data from experts that suggest best to do twice a day, or just don’t tell them..

The starting dose can depend on cats weight and what food they are on, if already on low carb food, the starting dose is a little lower. Definitely good info for this over on Lantus (glargine) forum.
Click to expand...
Excellent suggestion thank you. We have switched his food as well so there is that variable shifting results as well. I will post his food and weight.
 
No, I apologize for being confusing...We are going back to one unit every twelve hours the way the doctor originally prescribed. The doctor I talked to today suggested I give half a unit once a day and the whole unit for the second dose if Sabu's BL was dropping low. I am not comfortable with that suggestion though. Tonight Sabu had a whole unit. Tommorrow I am doing a twelve hour BL curve to see how his levels look throughout the day.
 
Kathleen Tyrrell said:
No, I apologize for being confusing...We are going back to one unit every twelve hours the way the doctor originally prescribed. The doctor I talked to today suggested I give half a unit once a day and the whole unit for the second dose if Sabu's BL was dropping low. I am not comfortable with that suggestion though. Tonight Sabu had a whole unit. Tommorrow I am doing a twelve hour BL curve to see how his levels look throughout the day.
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Keeping a dose consistent is very important with gargline insulins, because they form a depot sort to speak in the body is like a little bit of the insulin from each dose is left going around in the body and if you start changing the dose sometimes you are going to have a little left sometimes a lot and that can cause waky numbers and ups and downs you do not want (I'm oversimplifying but this is the idea), if what the vet wants is to give 1.5 units total during the day you could then give 0.75 units every 12 hours
 
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